Postnatal management of resolving fetal lung lesions
Postnatal management of resolving fetal lung lesions
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DOI：
10.1542/peds.109.1.105
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发表时间：
2002-01-01
期刊：
影响因子：
8
通讯作者：
Meizner, I
中科院分区：
文献类型：
--
作者：
Blau, H;Barak, A;Meizner, I
目标.自从常规产前超声出现以来，肺部病变的诊断越来越多。在15%至30%的病例中，这些病变似乎是内卷的。产后评估通常是有限的，特别是当重复超声或初始胸片正常。由于可能需要仔细随访或切除，因此准确的诊断至关重要。本研究的目的是确定是否产前肺部病变似乎解决仍然存在时，更密切的评价。我们对24例产前诊断为肺部病变的病例进行了随访，使用重复胸片和胸部计算机断层扫描（CT）。部分病灶引起轻度纵隔移位，但无胎儿水肿。在7例病例中，最后一次产前超声检查为阴性。在15例病例中，出生后首次胸片正常，其中只有4例在后来的胸片中看到病变。然而，这种表面上的高解决率是令人误解的。23例CT检查中22例明确显示肺囊肿或肺叶过度膨胀。产前连续超声或新生儿胸片上肺部病变明显复旧可能会引起误解。我们强烈建议对所有病例重复进行X线片和胸部CT检查以明确诊断。
Objectives. Lung lesions are increasingly diagnosed since the advent of routine prenatal ultrasound. These lesions seem to involute in 15% to 30% of cases. Postnatal evaluation is frequently limited, particularly when repeated ultrasound or initial chest radiographs are normal. As careful follow-up or resection may be required, accurate diagnosis is essential. The objective of this study was to determine whether prenatal lung lesions that seem to resolve are still present when evaluated more closely.Methods. We followed 24 cases of prenatally diagnosed lung lesions at our center, using repeated chest radiographs and chest computerized tomography (CT).Results. Some lesions caused mild mediastinal shift, but none showed hydrops fetalis. In 7 cases, the last prenatal ultrasound was negative. In 15 cases, initial postnatal chest radiograph was normal and in only 4 of these, the lesion was seen on later chest radiographs. This apparently high rate of resolution was, however, misleading. In 22 of the 23 cases in which CT was performed, lung cysts or lobar overinflation was clearly demonstrated.Conclusions. Apparent involution of lung lesions on serial prenatal ultrasounds or neonatal chest radiograph can be misleading. We strongly recommend repeated radiographs and chest CT for definitive diagnosis in all cases.