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We describe a case of fetal sacrococcygeal teratoma detected by ultrasound at 14 gestational weeks. The tumor was classified as "type Ⅰ" by ultrasonography combined with MRI. The cystic part accounted for over 60% of the mass before 26 weeks and ruptured spontaneously at 28 weeks. The size of the tumor was 12.8 cm×9.7 cm×12.3 cm at 36 +5 gestational weeks. A female newborn was born through cesarean section at 37 weeks of gestation and had the tumor removed surgically on the postnatal day 4. Postoperative follow-up showed that the neonate had a good prognosis without physiological dysfunction.
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We describe a rare case of fetal mediastinal capillary hemangioma presenting as pleural effusion and a huge pleural occupying lesion during late pregnancy. The patient was admitted at 36 +3 weeks of gestation, with a fetal chest occupying lesion for 11 days. Routine prenatal ultrasound and MRI indicated right pleural effusion and a huge chest occupying lesion in the fetus. The woman was administered oxytocin and delivered a live baby boy at 36 +5 weeks of gestation. The baby was diagnosed as mediastinal hemangioma by postnatal CT, angiography and 3D reconstruction and was discharged after oral propranolol treatment. However, he was readmitted one month after birth due to "pneumonia and tachypnea". After multidisciplinary consultation, the baby underwent a right-side thoracic mediastinal mass resection, and a mediastinal capillary hemangioma was confirmed by pathology. The child continued taking propranolol orally and received regular follow-up and rehabilitation after the operation up to 7 months old, by which time no obvious abnormalities were found.
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Objective To summarize the prenatal ultrasonographic characteristics of anomalous origin of one pulmonary artery from the aorta( AOPA ) ,and describe the diagnostic and clinical outcomes of fetal AOPA . Methods Echocardiographic characteristics of 3 fetuses with AOPA were reviewed . The ultrasonographic features were comparatively analyzed with postpartum autopsy findings . The relevant literature were reviewed and the experience of prenatal diagnosis of AOPA were summarized . Results In 3 cases with AOPA ,2 cases were the proximal type and anomalous origin of right pulmonary artery from the aorta ,of them ,one was accompanied with coarctation of the aorta , the other was accompanied with aortopulmonary window . One case was the distal type and anomalous origin of left pulmonary artery from the left innominate aorta ,it was only associated with mirror right aortic arch and right ductus arteriosus . Ultrasound characteristics were no bifurcation in distal pulmonary artery ,main trunk of pulmonary artery extends directly to one branch ,the other branch originated from the ascending aorta or left innominate artery . Three cases were confirmed by postpartum autopsy . Conclusions There are some characteristic signs on ultrasonic features of AOPA . Prenatal ultrasound has important value for diagnosis of AOPA .
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Objective To explore the value of three-vessel and trachea(3VT) view plus aortic arch coronal section in ultrasonic diagnosis and classification of fetal right aortic arch(RAA).Methods Echocardiography data and follow-up results of 44 fetuses with RAA were retrospectively analyzed.Sonographic features on 3VT view and aortic arch coronal section were summarized.Results Among 44 fetuses with RAA,27 cases(61.36%) were RAA with aberrant left subclavian artery(ALSA) and the left ductus arteriosus(LDA) connecting the ALSA and U-shaped vascular ring was formed;17 cases(38.64%) were mirror right aortic arch(MRAA).Among 17 cases with MRAA,3 cases were with LDA connecting the descending aorta(DAO) and U-shaped vascular ring was formed;1 case was with LDA connecting the left innominate artery(LINA),8 cases were with absent ductus arteriosus(ADA),5 case were with right ductus arteriosus(RDA),no vascular ring was formed.Parts of MRAA were combined with other complex intracardiac abnormalities.RAA-ALSA-LDA were rarely combined with intracardiac abnormalities.Conclusions 3VT view is simple and intuitive for diagnosing RAA.Aortic arch coronal section has great clinical value in determining the concrete type of RAA.
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Objective To explore the toxicity and safety of 32P-CP-PLLA seeds interstitial implantation. Methods 30 beagle dogs were randomly divided into 10 groups according to different drugs (32P-CP-PLLA and 32P-CP),different doses (185, 370 and 740 MBq) and different sites (gluteus and liver). At different time-points after surgery, the weights of dogs were measured. The blood routine and blood biochemical indexes,PC Ⅲ ,HA,CG,PCⅣ and LN were examined. ECT imaging was performed and histology was observed dynamically. Blood, urine and faeces were measured continuously for 12 weeks and 30 days, respectively. Results ECT imaging demonstrated in seed groups and 32P-CP muscle groups radioactivity concentrated continuously in the area of implantation, without liver imaging. 471.67 MBq/m2 of 32 P-CP was injected in liver,while the absorbed dose was 31 Gy,without significant liver damage. When the dose was 794. 28 MBq/m2 , the absorbed dose was 56 Gy,with strong liver and systemic toxicity. But implanting seeds at the same or higher dose, the absorbed dose was 89.83-178.68 Gy in the area of implantation, and the rest liver was 1.09-2. 18 Gy,without liver damage. Dogs in liver group died at 23, 29 and 45 d, respectively, and the inspections of liver fibrosis were higher than the means of the other groups.Blood routine and blood biochemistry indexes between the other groups showed no significant differences.Effective half-life of 32P-CP-PLLA was 11.78 d, while that of 32P-CP was 6. 82 d in liver, and 8. 73 d in gluteus. Mild to moderate injury were found in liver group at 4 weeks. Moderate to serious injury were found. Liver cell necrosis and proliferation were found at 4-6 weeks in other liver groups. In muscle groups,only cellular edema was found in muscle groups at 2 week. The radioactivity count rate in blood for seed groups showed slowly jagged decreasing over time, and decreased exponentially for 32PCP groups. The radioactivity count rate in urine and faeces were multi-peak descending in seed groups. Conclusions 32P-CP-PLLA seeds have the advantages of suitable target location, degradable, non-migration and easy to protection, and it could be used in treatment for different blood supply types of solid tumors. Liver of beagle dog could endure the dose from 32 P-CP-PLLA seed twice as 32P-CP lethal dose.