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目的:探讨产前超声在胎儿肾上腺区肿块定位、定性诊断及指导预后的价值。方法:以病理及随访结果为标准,回顾性分析长沙市妇幼保健院43例胎儿肾上腺区肿块的临床资料、超声声像图特征、预后结果,并进行统计学分析。结果:本组172 561例胎儿中产前超声检出43例肾上腺区占位病变,检出率2.49/10 000(43/172 561)。肾上腺血肿19例(其中5例不排除为肾上腺神经母细胞瘤可能),膈下型隔离肺10例,肾上腺囊肿8例,肾上腺神经母细胞瘤3例,肾上腺畸胎瘤3例。产前超声定位诊断符合率100%。膈下型隔离肺的孕周早于神经母细胞瘤、血肿、畸胎瘤及囊肿(n P=0.035、0.031、0.043、0.025),其他各组之间比较差异无统计学意义(n P>0.05)。各组肿块直径之间比较差异无统计学意义(n P>0.05)。膈下型隔离肺的初始发现孕周最早,43例胎儿出生,其中18例行手术治疗,24例观察,1例放弃治疗并在随访中死亡,其余病例预后良好。n 结论:产前超声对胎儿肾上腺区占位病变的产前诊断及鉴别诊断具有很好的优势;该类患儿总体预后良好。“,”Objective:To evaluate the value of prenatal ultrasound in localization, qualitative diagnosis and prognosis of adrenal mass in fetus.Methods:According to the pathological and follow-up results, the clinical data, ultrasonographic features and prognostic results of 43 cases of fetal adrenal mass in Changsha Maternal and Child Health Hospital were collected and analyzed, and statistical analysis was performed.Results:In this group, 43 cases of adrenal mass lesions were detected by prenatal ultrasound in 172 561 fetuses, with a detection rate of 2.49/10 000 (43/172 561). There were 19 cases of adrenal hematoma (5 cases were not excluded as adrenal neuroblastoma), 10 cases of subphrenic free lung, 8 cases of adrenal cyst, 3 cases of adrenal neuroblastoma, and 3 cases of adrenal teratoma. The coincidence rate of prenatal ultrasound diagnosis was 100%. The gestational weeks of isolated lung were earlier than those of neuroblastoma, hematoma, teratoma and cyst (n P=0.035, 0.031, 0.043, 0.025), but there was no significant difference among other groups (n P>0.05). There was no significant difference in tumor diameter among the groups (n P>0.05). The initial finding of subphrenic free lung was the earliest at the gestational week, 43 fetused were born, 18 cases were treated with surgery, 24 cases were observed, 1 case was abandoned for treatment, follow-up found that the prognosis of the other cases were good except for 1 death.n Conclusions:Prenatal ultrasound has a good advantage in prenatal diagnosis and differential diagnosis of adrenal mass lesions. The overall prognosis of fetal adrenal masss is good.