Clinical value of serial ultrasonography in the dynamic observation of foetal cystic adrenal lesions

Wang, Liang; Zhan, Wei; Wu, Dazhou; Ni, Xianwei; Luo, Hongxia; Yang, Yan

doi:10.1002/pd.5335

Cited by 5 publications

(7 citation statements)

References 24 publications

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“…The diagnostic accuracy rate of both reached 100%. Adrenal simple cysts are rare and appear purely cystic with a thin wall and no internal echoes of the cyst 14 . In this analysis, 3 cysts resolved spontaneously within 6 months after birth, and patients were in good condition.…”

Section: Discussionmentioning

confidence: 70%

“…In this analysis, 3 cysts resolved spontaneously within 6 months after birth, and patients were in good condition. Adrenal hemorrhage may occur before birth 14 . The ultrasound findings of fetal adrenal hemorrhage may change over time.…”

Section: Discussionmentioning

confidence: 99%

“…Adrenal hemorrhage may occur before birth. 14 The ultrasound findings of fetal adrenal hemorrhage may change over time. And no blood flow can be seen within the mass with power Doppler examination.…”

Section: Renal/adrenalmentioning

confidence: 99%

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Fetal Abdominal Cystic Masses

Wang

Zeng

et al. 2022

J of Ultrasound Medicine

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Objectives To assess the diagnostic accuracy of prenatal ultrasound in detecting intra‐abdominal masses derived from different systems. Methods Fetuses diagnosed with abdominal cystic masses during prenatal ultrasound were included in this study. The basic biological parameters of the fetus were measured in addition to the location of the cystic mass, the shape and size of the mass, the thickness of the cystic wall, dynamic changes, blood supply of the mass, and relationship with the surrounding organs. Whether the fetus also had other malformations was also recorded. Clinical data were followed up to 6 months after birth. Results Between January 1, 2019 and January 1, 2021, 247 fetuses were included, most of which contained renal/adrenal cystic masses (n = 93, 37.7%), followed by hepatobiliary system (n = 48, 19.4%), gastrointestinal tract (n = 45, 18.2%), reproductive system (n = 29, 11.7%), and ureter and bladder (n = 27, 10.9%) masses, respectively. The minority were masses in other systems (n = 5, 2.0%). The overall prenatal diagnostic accuracy was 90.7%. There were significant differences in each system (χ2 = 13.0, P < .05). The most accurate type of cyst was diagnosed from renal and adrenal (96.8%) cases, followed by ureter and bladder (92.6%) cases, gastrointestinal tract (91.1%), hepatobiliary system (85.4%), and reproductive system (82.8%). Other systems (60.0%) were the least accurate type. Conclusions A wide variety of cystic masses can be accurately detected in the fetal abdomen, and most of these lesions can be accurately diagnosed during pregnancy.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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Fetal Abdominal Cystic Masses

Wang

Zeng

et al. 2022

J of Ultrasound Medicine

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“…Adrenal insufficiency is found very rarely, even in cases of bilateral adrenal hemorrhage. 25 Isolated adrenal cysts (case 5; Table 1 and Figure 7) can occur unilaterally. Differential diagnoses of neuroblastoma (cystic form) and an adrenocortical macrocyst (Beckwith-Wiedemann syndrome) should be kept in mind.…”

Section: Discussionmentioning

confidence: 99%

“…A fetal adrenal hemorrhage can regress and disappear spontaneously during the prenatal period. Adrenal insufficiency is found very rarely, even in cases of bilateral adrenal hemorrhage 25 …”

Section: Discussionmentioning

confidence: 99%

Prenatal Assessment of Atypical Adrenal Glands

Lesieur

Noire²,

Maurice

et al. 2020

J of Ultrasound Medicine

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The aim of this study was to identify specific unusual prenatal ultrasound (US) patterns of the adrenal gland and to propose a systematic approach for diagnosis. Six fetuses with unusual aspects of one or both adrenal glands, detected during routine prenatal US screening, were evaluated. Prenatal and postnatal management are described. A checklist of US features was created to perform a detailed analysis of adrenal lesions and guide prenatal management; this includes the time of appearance, location, growth, vascularization, structure, and presence of findings suggestive of malignancy.

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Imaging and outcomes of fetal adrenal hemorrhage: A systematic review

Pham,

Biswas,

Levy

et al. 2023

Prenatal Diagnosis

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ObjectiveTo describe prenatal and postnatal imaging findings of fetal adrenal hemorrhage (FAH) and its associated perinatal outcomes, including frequency of postnatal surgical intervention.MethodA systematic literature review of seven electronic databases was conducted from inception until January 2022, with 2008 articles identified reporting prenatally identified fetal adrenal masses. Studies with confirmed FAH diagnosis were included. Quality and risk assessment were evaluated.ResultsThirty‐five studies, including 102 FAH cases, were analyzed. FAH was commonly described as cystic (28/90, 31%), anechoic (25/90, 28%), or mixed echogenic (14/90, 16%) on ultrasound. Outcome data were available for 65 cases (64%) of FAH: 9% (6/65) resolved prenatally, 35% (23/65) resolved postnatally, 34% (22/65) regressed in size after birth, and 22% (14/65) persisted postnatally. Overall, 25% (16/65) of cases underwent postnatal surgical intervention. Neuroblastoma was suspected in all 16 surgical cases. Only one case (1/16, 6%) confirmed a cystic hematoma with microscopic islets of neuroblastoma in situ on pathology.ConclusionPrenatal diagnosis of FAH is challenging due to the significant heterogeneity of ultrasound findings. Final pathology did not support the need for surgical intervention. Persistent postnatal FAH warrants shared decision making for further management based on the clinical presentation.

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Clinical value of serial ultrasonography in the dynamic observation of foetal cystic adrenal lesions

Abstract: The ultrasonographic findings of foetal cystic lesions in the adrenal gland and the change they undergo after birth may provide valuable information for clinical diagnosis.

Cited by 5 publications

References 24 publications

Fetal Abdominal Cystic Masses

Fetal Abdominal Cystic Masses

Prenatal Assessment of Atypical Adrenal Glands

Imaging and outcomes of fetal adrenal hemorrhage: A systematic review

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