产前超声诊断胎儿胆道囊性病变的价值

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1、中华超声影像学杂志2010年5月第19卷第5期ChinJ!0g!!!!!!!．·427·．临床研究．产前超声诊断胎儿胆道囊性病变的价值张一休孟华欧阳云淑姜玉新戴晴徐钟慧杨萌袁岩李鹏楼海亚杨筱【摘要】目的探讨产前超声对胎JI,,N道囊性病变的诊断价值。方法回顾性分析孕期于我院产前超声检出的3例胆道囊性病变，并随访至生后手术。结果3例胎儿分别于孕16周、孕26周、孕34周检出右上腹囊性包块，诊断为胆道囊性病变。生后手术确诊2例为胆总管囊肿，1例为胆道闭锁。2例胆总管囊肿最大径分别为3．9cm及4．2CN且随孕周逐渐增大，

2、胆囊清晰显示。1例胆道闭锁囊肿最大径1．7cm且整个孕期无明显变化，胆囊不显示或偶尔显示时体积小。3例患儿均在生后4个月内行肝管空肠Roux-enY吻合术，术后恢复良好。结论囊肿的体积及其变化、胆囊形态可以帮助鉴别胎儿胆道囊性病变。囊肿体积小且无增大伴胆囊不显示或胆囊体积小提示胆道闭锁。产前超声诊断可使患儿得到早期手术治疗，改善预后。【关键词】超声检查，产前；胆总管囊肿；胆道闭锁ValueofprenataluItrasOn0graphyindiagnosisoffetalbiliarycysticmalformat

3、ionZHANGYixiu，MENGHua，O(ryANGYunshu，JIANGYu—xin，DAIQing，XUZhong—hui，YANGMeng，YUANyn，LIPeng，LOUHai—ya，YANGXiao．DepartmentofUltrasound，PekingUnionMedicalCollegeHospital，ChineseAcademyofMedicalSciences，＆ing100730，ChinaCorrespondingauthor：JIANGYu—xin，Email：yuxinjia

4、ngxh@yahoo．corn．cn[Abstract]0bjectiveToinvestigatethediagnositicvalueofultrasonographyinfetuseswithcysticbiliarymalformation．MethodsThreecasesofcysticbiliarymalformationdiagnosedinourhospitalbyprenatalultrasoundwerefollowedupuntilsurgeryafterbirth．ResultsInallt

5、hreecases，ananechoiccysticlesionwasdetectedintherightupperabdomenat16，26，34weeksgestationrespectively，whichwerediagnosedasbiliarycysticmalformationbyprenatalultrasound．Twocaseswereconfirmedascholedochalcystbysurgery，onecaseasbiliaryatresia．Themaximumdiameterdur

6、ingpregnancyofcholedochalcystwere3．9cmand4．2C1TIrespectively，whichincreasedsteadilyasgestationalageadvanced，withnormalgallbladderincontinuitywiththecholedochalcyst．Butthelargestdiameterofthecystincongenitalbiliaryatresiawas1．7cmandremainedunchangedthroughoutthe

7、remainingpregnancy，thegallbladdercouldnotbedetectedoranirregularsmallgallbladderwasshown．ExcisionofthecystandRoux—en—Yhepaticojejunostomyweresuccessfullyperformedinallthreecases．Postoperativecoursewereuneventfu1．ConclusionsCystdiameter，changeinsize，gallbladderu

8、ltrasoundpatternmayallowtOmakeaprenataldifferentialdiagnosisofbiliarytreecysticmalformation．Smallandstablecystwithanundetectedgallbladderorsmallgallbladderismoresuggestiveof