Analysis Of Prenatal Ultrasonographic Features And Prognosis Of Fetal Ovarian Cyst

ObjectiveTo investigate the prenatal ultrasonographic features and prognosis of fetal ovarian cysts.MethodsRetrospective analysis was performed on 21 cases of fetal ovarian cysts diagnosed by prenatal ultrasound in Peking Union Medical College Hospital and Beijing Haidian District Maternal and Child Health Hospital from January 2015 to December 2019 with complete imaging data and prognosis,the characteristics of gestational age,echo and size at the time of detection were analyzed,and the correlation between the above signs and prognosis was summarized.ResultsAmong the 21 cases of fetal ovarian cysts,the gestational age of the first detection by prenatal ultrasound was 23 to 31 weeks.2 cases were found in middle pregnancy and 19 cases were found in late pregnancy.There were 20 unilateral cases(14 on the left side,6 on the right side)and 1 bilateral case.15 cases were simple fetal ovarian cysts,6 cases were complex fetal ovarian cysts,Median of the longest diameters are respectively 2.5(range 1.9-3.6)cm and 5.4(range 3.4-6.5)cm.Among the cysts larger than 4cm and smaller than 4cm,the proportion of complex ovarian cysts was respectively 66.7%and 13.3%.All the above differences were statistically significant.The internal echo texture of the complex fetal ovarian cyst can be manifested as intracapsular separation,debris,fluid level,irregular echo or hyper echo,the echo of the wall of the cyst thickened and enhanced,and"fishnet sign".Two cases of ovarian cysts pedicle torsion showed detritus,fluid level and thickening of the cyst wall echo.Changes in ovarian cyst location were observed in 1 case.The length diameter of fetal ovarian cysts in 19 cases reached the maximum at 30-33 weeks of gestation.The prenatal changes of 17 fetal ovarian cysts(13 cases of simple type and 4 cases of complex type)were consistent with the decreasing trend.Nineteen cases of fetal ovarian cysts(15 cases of simple type and 4 cases of complex type)spontaneously subsided prenatal or within 1 year after birth.Of the four cases that did not conform to the prenatal reduction trend,2 cases were simple ovarian cysts(1 case had no significant change in length diameter before birth,and 1 case had gradual increase in length diameter).The cysts all subsided after birth.Another 2 cases of complex ovarian cyst pedicle torsion underwent surgical treatment.ConclusionsComplex fetal ovarian cysts are larger than simple ovarian cysts,When the ultrasonic characteristics of debris,fluid level and echo thickening and enhancement of the cyst wall appear,they have diagnostic significance for cysts pedicle torsion.The thickening and enhancement of the echo of the cyst wall and the change of the ovarian position are specific for the diagnosis of fetal ovarian cyst pedicle torsion.Most of the ovarian cysts in the prenatal basic accord with the trend of narrowing;Most of the ovarian cysts,especially simple cysts,may subside spontaneously before or after delivery.Prenatal complex cysts that do not shrink gradually and the volume is larger should be cautious of the possibility of pedicle torsion.