Fetal adrenal area space-occupying lesions: prenatal diagnosis on ultrasound and prognosis

Abstract

Objective To explore the prenatal ultrasonic types, sonographic features of malformation, ultrasonic diagnosis and prognosis of fetuses with adrenal area space-occupying lesions. Methods Forty-four fetuses with adrenal area space-occupying lesions were retrospectively analyzed. Compared with postpartum neonatal special inspection results or the anatomical and pathological examination results of the corpses after induced labor, the ultrasound types, sonographic feature, the key points of differential diagnosis were summarized. The newborns were followed up to 6 months after birth, tracking the prognosis. Results Totally 44 fetuses among 166 471 fetuses(166 471 pregnant women) were detected with adrenal area space-occupying lesions, 41 cases after delivery, including 24 cases adrenal hematoma(2 cases prenataly misdiagnosed as neuroblastoma), 14 cases adrenal cyst and 3 cases neuroblastoma, were accurately diagnosed through color Doppler or MRI or CT or pathological examination results. Three cases after induced labor, including 1 case adrenal neuroblastoma, 1 case mullerian duct cyst and 1 case adrenal hematoma(prenataly misdiagnosed as neuroblastoma) were confirmed through the anatomical and pathological examination results of the corpses. So the conformity rate of adrenal area space-occupying lesions was 90.9%(40/44). The postnatal ultrasound showed that the tumor disappeared in twenty-four cases of adrenal hematoma without surgery, and the longest time of the tumor disappearance was 1 year. The size of 14 cases adrenal cyst had no obvious change. One case of adrenal neuroblastoma was operated at 2 months, 2 cases were operated at 2 years of age. Conclusions Ultrasound can be used as qualitative diagnosis and differential diagnosis for fetal adrenal area space-occupying lesions. The majority of the children with adrenal area space-occupying lesions have a good prognosis. Key words: Ultrasonography, prenatal; Fetus; Adrenal gland diseases