产前超声对胎儿骶尾部畸胎瘤的诊断价值

目的探讨胎儿骶尾部畸胎瘤产前超声表现及超声诊断价值。 方法对2000年2月至2015年11月在解放军总医院产前超声检查及剖宫产娩出后手术病理检查证实骶尾部畸胎瘤的15例胎儿的超声病理资料进行回顾性分析。 结果15例胎儿产前超声表现：（1）8例胎儿骶尾部肿瘤大小（4.3±2.7）cm，其内以囊性为主回声5例、囊实混合性回声2例、实性为主回声1例，其内见钙化样强回声7例，未见钙化样强回声1例；肿瘤内均未见明显血流信号；超声诊断畸胎瘤Ⅰ型1例、Ⅱ型1例、Ⅲ型3例、Ⅳ型3例；手术病理均诊断为成熟性畸胎瘤。（2）7例胎儿骶尾部肿瘤大小（11.6±5.1）cm，其内均以实性回声为主；多血供5例，少血供2例；7例均可见钙化样强回声分散于低回声内；合并羊水过多5例；超声诊断畸胎瘤Ⅰ型2例、Ⅱ型3例、Ⅲ型1例、Ⅳ型1例；手术病理均诊断为未成熟性畸胎瘤。 结论产前超声可显示胎儿骶尾部畸胎瘤的部位、大小、内部回声、血流信号及其与周围脏器的关系，产前超声正确诊断对胎儿预后判断及分娩方式的选择有重要参考价值。

The diagnostic value of prenatal ultrasonography in fetal sacrococcygeal teratoma

ObjectiveTo discuss the manifestation of prenatal ultrasonography in fetal sacrococcygeal teratoma and its diagnostic value. MethodsUltrasonographic and pathological data of 15 cases with surgical pathologic examination confirmed fetal sacrococcygeal teratomas after prenatal ultrasonographic examination and cesarean delivery were retrospectively analyzed from February 2000 to November 2015 in Chinese PLA General Hospital. ResultsPrenatal ultrasonography imaging feature of 15 cases: (1) The 8 cases of fetal sacrococcygeal teratoma, size (4.3±2.7) cm, with predominant fluid components in 5 cases, mixed with fluid and solid components in 2 cases, predominant solid components in 1 case; with internal calcification-like strong echo in 7 cases and without internal calcification-like strong echo in 1 case; no obvious blood flow signal was detected in all cases; typeⅠ(1 case), typeⅡ(1 case), type Ⅲ (3 cases), type Ⅳ(3 cases) by prenatal ultrasonography; which were diagnosed as mature teratomas by surgery and pathology. (2) The 7 cases of fetal sacrococcygeal teratoma, size (11.6±5.1) cm, with predominant solid components in 7 cases; with obvious blood flow signal inside in 5 cases and with little blood flow signal inside in 2 cases; all with calcification-like strong echo scattered in low echo; with polyhydramnios in 5 cases; typeⅠ(2 cases), typeⅡ(3 cases), type Ⅲ (1 case) and type Ⅳ(1 case) by prenatal ultrasonography; which were diagnosed as immature teratomas by surgery and pathology. ConclusionPrenatal ultrasound can accurately show the lesion location, size, internal echo, blood flow and the relationship with the adjacent organs of fetal sacrococcygeal teratoma, and the ultrasound diagnosis of fetal sacrococcygeal teratoma has important reference value for prognostic evaluation and the selection of delivery mode.