盆腔脂肪增多症的超声诊断及漏误诊原因分析  

Ultrasound diagnosis of pelvic lipomatosis and misdiagnosis analysis

作　　者：唐天虹 苏娜 孙伟[2] 刘思锐 王铭 齐振红 李建初 杨萌 姜玉新 Tang Tianhong;Su Na;Sun Wei;Liu Sirui;Wang Ming;Qi Zhenhong;Li Jianchu;Yang Meng;Jiang Yuxin(Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100730,China;Department of Ultrasound,Daqing Oilfield General Hospital,Daqing,Heilongjiang Province 163001,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院超声医学科,100730 [2]大庆油田总医院超声科,黑龙江省大庆市163001

出　　处：《中华超声影像学杂志》2020年第4期359-363,共5页Chinese Journal of Ultrasonography

基　　金：北京市自然科学基金杰出青年科学基金(JQ18023);国家自然科学基金(81301268);北京市科技新星计划交叉学科合作计划(XXJC201812);国家国际科技合作专项项目(2015DFA30440)。

摘　　要：目的:探讨盆腔脂肪增多症(pelvic lipomatosis,PL)的超声诊断价值,并分析漏误诊原因。方法:回顾性分析2000年1月至2018年12月在北京协和医院经手术或影像学确诊为PL的68例患者,总结其超声图像特征。结果:68例PL患者的声像图表现如下:盆腔内脂肪样强回声增多6例(8.8%),膀胱异常60例(88.2%),肾盂扩张42例(61.7%),合并输尿管扩张24例(35.3%)。其中超声正确诊断6例(8.8%);漏诊54例(79.4%);误诊为其他疾病8例(11.8%),包括膀胱肿瘤性占位7例(10.3%),腹膜后巨大占位1例(1.5%)。结论:PL具有特征性的声像图表现,当发现泌尿系统梗阻及膀胱壁增厚等超声表现时,需考虑PL存在的可能,并进一步观察膀胱形态及盆腔内有无脂肪样强回声增多等表现,这有助于降低PL超声诊断的漏误诊率。Objective To discuss the value of ultrasound in the diagnosis of pelvic lipomatosis and analyze the causes of misdiagnosis.Methods A retrospective analysis of 68 cases of pelvic lipomatosis confirmed by operation or imaging in Peking Union Medical College Hospital from January 2000 to December 2018 was made to summarize the characteristics of ultrasonic manifestations.Results Ultrasonographic findings were as follows:6 cases(8.8%)had increased fat-like hyperecho in pelvic cavity;60 cases(88.2%)had abnormal bladder;42 cases(61.7%)had pyelectasis and 24 cases(35.3%)had ureterectasis.Of the 68 cases,6 cases(8.8%)were correctly diagnosed;54 cases(79.4%)were missed;8 cases(11.8%)were misdiagnosed,including 7 cases(10.3%)of bladder tumor and 1 case(1.5%)of retroperitoneal giant mass.Conclusions Pelvic lipomatosis has characteristic sonographic features.When urinary tract obstruction and bladder wall thickening are observed,pelvic lipomatosis should be considered.Bladder shape and existence of increasing fat-like hyperecho in the pelvis should be further scanned to reduce the misdiagnosis rate of pelvic lipomatosis.

关 键 词：超声检查 盆腔脂肪增多症 误诊 

分 类 号：R44[医药卫生—诊断学] R711[医药卫生—临床医学]