Prenatal diagnosis of fetal lung masses by ultrasonography and its clinical significance

Abstract

Objective To analyze the ultrasonographic features of fetal lung masses and their clinical prognosis. Methods There were total 38 fetuses with lung masses detected by prenatal ultrasonography in Suzhou Hospital Affiliated to Nanjing Medical University during June 1st 2011 to May 31st 2013. They were followed up to birth or induction of labor. Prenatal ultrasonographic features were analyzed by comparing to the CT examinations after birth or autopsy. Results Among 38 fetuses, there were 20 fetuses with cystic adenomatoid malformation (CAM) and 18 with pulmonary sequestration (PS) diagnosed by prenatal ultrasonography, and most of them were confirmed by CT after birth or autopsy. Their ultrasonogrphic characteristics and outcome were as followings. (1) Among 20 fetuses with CAM, there were 4 cases of CAM type Ⅰ, and their ultrasonography showed polycystic anechoic areas. Ultrasonography showed mixed echoic areas in 7 cases of type Ⅱ, and hyperechoic areas in 9 cases of type Ⅲ. After prenatal ultrasonography, 2 cases chose termination of pregnancy and were confirmed by autopsy. Lung masses in 6 cases disappeared gradually during follow up. Eleven cases were confirmed as CAM by CT after birth. However 1 case was missed follow-up. (2) Ultrasonography showed well-defined wedge-shaped hyper echo in 18 cases of PS, and color Doppler flow imaging (CDFI) showed that their blood supply were all from systemic circulation. Among 15 cases who underwent natural labor, masses in 9 cases disappeared during follow-up, and 6 cases were confirmed by CT after birth. The other 3 cases were missed. Conclusions Fetal lung masses have different ultrasonographic characteristics. Early and exact diagnosis has great significance for fetal prognosis and clinical management. Key words: Ultrasonography, prenatal; Fetus; Lung mass; Cystic adenomatoid malformation of the lung; Pulmonary sequestration