【摘要】 目的 通过对早期妊娠卵黄囊的观察，探讨其在早孕超声诊断中的临床价值。 方法 2008年5月-2009年1月应用阴道超声诊断仪观察536例早孕患者卵黄囊的形态、大小及卵黄囊的数目，根据结果分为卵黄囊正常及异常组，比较卵黄囊的增长情况与妊娠预后的关系。 结果 504例正常组中，501例正常妊娠结局的卵黄囊大小从孕5~11周持续增长，此后逐渐缩小，孕12周后消失；另3例为宫外孕而中止妊娠。卵黄囊异常组32例。正常组和异常组的卵黄囊大小及形态有统计学意义（Plt;0.05）。 结论 卵黄囊超声影像学改变可作为诊断早孕及预测妊娠发展和转归的可靠手段。【Abstract】 Objective To evaluate the clinical value of yolk sac in the diagnosis of early pregnancy by observing the change of yolk sac. Methods The yolk sacs in 536 pregnant women were measured by ultrasonogaphy from May 2008 to January 2009, and the correlation of the growth condition of the normal or abnormal yolk sac with pregnancy outcome were observed. Results In the normal group (504 patients), the yolk sac size of 501 patients continued to grow from five to 11 weeks of pregnancy, then gradually reduced and disappeared after 12 weeks of pregnancy. The other three patients terminated pregnancy because of ectopic pregnancy. Thirty-two cases of abnormal yolk sac were found. The results showed the size and shape of yolk sacs were significantly different between normal and abnormal groups (Plt;0.05). Conclusion The change of yolk sacs by ultrasonography during early pregnancy can be used as a good measure to diagnosis early pregnancy and predict the development and prognosis of pregnancy.
ObjectiveTo explore the differences in ultrasonographic features of testicular teratoma and yolk sac tumor (YST) in children.MethodsA total of 44 patients were selected, including 30 with testicular teratoma and 14 with YST, whose diagnoses were confirmed by surgery and pathology in West China Second University Hospital, Sichuan University from January 2015 to June 2019. The differences in ultrasonograhic characteristics of the two groups were compared, such as the size, location, internal echo, composition, and blood supply of the tumors.ResultsThe mean value of maximum diameters of testicular teratomas was (24.25±12.13) mm and that of YSTs was (29.71±18.75) mm, with no statistically significant difference between the two groups (F=0.531, P=0.383). In terms of the compositions of the tumors, cystic-solid lesions were the most common in testicular teratomas (17/30), followed by solid lesions (8/30) and cystic lesions (5/30); while solid lesions were the most common in YSTs (12/14), followed by cystic-solid lesions, and cystic lesions did not appear. The difference in the compositions of tumors was statistically significant between children’s testicular teratomas and YSTs (P=0.001), especially in the proportion of solid lesions. In terms of Adler grade of blood flow, there were 9 cases of Adler 0, 10 cases of Adler 1, 10 cases of Adler 2, and 1 case of Adler 3 in testicular teratomas, while there were 0 case of Adler 0, 1 case of Adler 1, 4 cases of Adler 2, and 9 cases of Adler 3 in YSTs. The difference in the blood supply was statistically significant between children’s testicular teratomas and YSTs (P<0.001). Testicular teratomas tended less to behave as Adler 3, while Adler 3 was the most common in YSTs. There was no statistically significant difference in other ultrasonic features, like the location, internal echo, or the existence of calcification (P>0.05).ConclusionsUltrasound has a certain meaning for the differential diagnosis of testicular teratoma and YST in children. By comparing the solid component and the blood supply of the tumor, it is helpful for enhancing the diagnostic confidence of sonographer.
ObjectiveTo investigate the clinical characteristics and treatment of primary mediastinal yolk sac tumor (PMYST). MethodsWe collected the clinical data of PMYST patients who were admitted to the Department of Thoracic Surgery of Peking Union Medical College Hospital from September 2000 to September 2020. The clinical and pathological characteristics, treatment and prognosis of PMYST patients were retrospectively analyzed. Results Finally 18 patients were enrolled, including 17 males and 1 female with a median age of 22.0 (16.6, 26.2) years. Patients had increased level of alpha fetoprotein (AFP). The pathological type can be single yolk sac tumor or combined with other mediastinal germ cell tumors. Chemotherapy and radical surgery were the main treatment methods. Extensive resection was feasible for patients with tumor invasion of other organs. Seven patients developed lung or pleural metastasis after operation, and 3 of them had extrapleural metastasis. One patient recurred within 1 year after surgery. All patients were followed up by telephone or outpatient department. At the last follow-up, 5 patients survived, 9 died, and 4 were lost to follow up, with a median survival of 16.8 months. The median disease-free survival was 14.9 months. The survival rates at 1, 3 and 5 years were 73.3%, 28.6% and 11.8%, respectively. ConclusionPMYST often occurs in young-middle aged male patients. Preoperative puncture can provide an effective diagnostic basis. R0 resection, AFP returning to normal after treatment and no metastasis may be potential indicators of good prognosis. The overall prognosis of PMYST is poor, and some patients can achieve long-term survival after treatment.