Prenatal Diagnostics of Sacrococcygeal Teratomas - is Everything Always Obvious?
Precise differential diagnosis of fetal pelvic lesions is crucial for determining prognosis and management, as well as for prenatal counselling.Purpose. To analyze ultrasound and MRI-features of prenatally diagnosed sacrococcygeal teratomas (SCT) (types III-IV) and ovarian cysts and to define the most significant differential sings of teratomas with intrapelvic component. Materials and methods. Analysis of ultrasound and MRI-features, complications of pregnancy and outcomes in 8 cases of prenatally diagnosed sacrococcygeal teratomas (types III-IV) and 49 cases of abdominal/pelvic lesions (ovarian cysts). Results. Only 37.5% of SCT of types III-IV have been diagnosed before 22 weeks of gestation, mean gestational age at the diagnosis was 29.6 (25-36) weeks, pregnancies have been complicated in 5 (83.3%) cases; mean gestational age at diagnosis of ovarian cysts was 34.1 (29.3-37.4) weeks, there were not complications of pregnancy because of cysts. Relative risk (RR) of being SCT is being increased when the lesion has thick wall ≥2 mm (RR=39.2 (95% CI 5.4-286.4)), hyperechoic inner components (RR=32.0 (95% CI 4.2-241.3)), solid component (RR=25.5 (95% CI 6.6-99.2)), high vascularity (RR=17.3 (95% CI 5.8-52.0)).Conclusions. The most relevant differential features of teratomas with intrapelvic component are thick wall, hyperechoic inner components, solid component, high vascularization along with visualization of suspension inside the lesion and its heterogenicity and development of hydronephrosis, ascites and anterior displacement of the bladder.