36例胎儿心脏肿瘤的超声与病理对比研究

目的:与病理对照探讨胎儿超声心动图对胎儿心脏肿瘤的诊断价值。方法:收集我院及多中心2011年至2018年,经超声心动图诊断的胎儿心脏肿瘤65例,其中36例胎儿终止妊娠并于我院病理科进行尸体解剖及遗传学检测。结果:病理诊断横纹肌瘤33例,纤维瘤1例,血管瘤1例,下腔静脉瓣增生1例,超声心动图定性诊断的准确率为91%。35例心脏肿瘤中,30例肿瘤的诊断准确,准确率为85.7%,4例将单发占位误诊为单发占位,1例将多发占位误诊为多发占位。对36例胎儿进行结节性硬化症遗传学检测,阳性22例,阴性12例,组织降解2例。结论:胎儿超声心动图诊断的胎儿心脏肿瘤,以横纹肌瘤最为常见。超声心动图容易将心室内的粗大肌束误诊为心脏肿瘤,应注意鉴别。对胎儿心脏肿瘤的病例应及时行结节性硬化症遗传学检测。

A comparative study of fetal cardiac tumors of 36 by ultrasonography and pathology

Objective:To explore the diagnostic value of fetal echocardiography in fetal cardiac tumors.Methods:From 2011 to 2018,65 fetuses with cardiac tumors diagnosed by echocardiography in our hospital and multicenter units were collected.Of them,36 fetuses terminated pregnancy and underwent autopsy in the pathology department of our hospital and genetic testing.Results:Pathological diagnosis included rhabdomyoma in 33,fibroma in 1,inferior vena cava valve hyperplasia in 1 and hemangioma in 1,the accuracy of qualitative diagnosis by echocardiography was 91%.Among 35 cases of cardiac tumors,30 cases were accurate in diagnosing the number of tumors,and the accuracy rate was 85%,4 cases misdiagnosed single occupancy as multiple occupancy,and 1 case misdiagnosed multiple occupancy as multiple occupancy..36 fetuses were underwent genetically tested for tuberous sclerosis,22 positive cases,12 negative cases and 2 tissue degradation cases.Conclusions:Rhabdomyoma is the most common fetal cardiac neoplasm diagnosed by fetal echocardiography.Echocardiography is easy to misdiagnose the intraventricular muscular tract as a cardiac neoplasm,so attention should be paid to the differential diagnosis.The genetic detection of TSC should be performed in cases of fetal cardiac tumors in time.