Prenatal ultrasonographic diagnosis and prognosis of congenital cystic adenomatoid malformation / 中华医学超声杂志（电子版）

ABSTRACT

Objective To investigate the ultrasound characteristics of congenital cystic adenomatoid malformation (CCAM). Methods The ultrasonographic features of 21 cases of fetal CCAM confirmed by prenatal ultrasound were analyzed. And ultrasound ifndings were compared with the postnatal thoracic computed tomography (CT), surgical result and follow-up data. Results (1) Prenatal ultrasonographic ifndings:2 cases of CCAM typeⅠ(10%, 2/21), 13 cases of typeⅡ(62%, 13/21), and 6 cases of typeⅢ(28%, 6/21). Of them, 95%(20/21) lesions were located in unilateral thorax, while 5%(1/21) in bilateral thorax. CCAM was ifrst detected at 18th-25th gestational week with a median of 22nd week. The CVR was1.6 in 16 (76%, 16/21) and 5 (24%, 5/21) cases respectively. After reaching the maximum volume, the size of mass remained stable in 8 cases and regressed in 13 cases with even complete remission in 5 cases. There were mediastinal shift in 19 fetuses (90%, 19/21), polyhydramnios in 6, and concomitant structural abnormalities in 3 cases such as pulmonary sequestration, diaphragmatic hernia and fetal hydrops. (2) Clinical outcomes:15 newborns were conifrmed as CCAM by CT, in which 9 cases underwent surgical resection. One case was conifrmed by autopsy. Nineteen cases showed good prognosis. Whereas 1 pregnancy with fetal hydrops was terminated, and 1 fetus with diaphragmatic hernia died after birth. Conclusions Dynamic prenatal ultrasound assessment is the key factor in prognosis prediction of fetal CCAM. CCAM without other structural abnormalities has a good outcome.