经阴道三维超声检查子宫内膜息肉的漏诊误诊原因分析  

Reasons for Missed Diagnosis and Misdiagnosis of Endometrial Polyp by Transvaginal Three-dimensional Ultrasonography

作　　者：宋若玲 李留霞[1] 刘艳芳 黄彦文 SONG Ruoling;LI Liuxia;LIU Yanfang;HUANG Yanwen(Department of Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院妇科,河南郑州450052

出　　处：《河南医学研究》2022年第1期98-101,共4页Henan Medical Research

基　　金：2017年度医学会推广项目(2017T02021)。

摘　　要：目的探讨经阴道三维超声检查子宫内膜息肉(EP)的漏诊误诊原因。方法选取2019年1月至2021年1月于郑州大学第一附属医院妇产科就诊的350例异常子宫出血患者,经阴道三维超声诊断EP者227例,诊断非EP者123例。以病理结果为金标准,对经阴道三维超声漏诊误诊EP的病例资料进行回顾性分析。结果经阴道三维超声对EP诊断的准确度、误诊率、漏诊率分别为72.57%(254/350)、29.85%(20/67)、26.86%(76/283)。在被误诊为EP的20例病例中,8例为子宫内膜良性增生症,4例为子宫黏膜下肌瘤,3例为慢性子宫内膜炎,5例为正常增生期/分泌期内膜。在漏诊的76例EP病例中,48例为增生型息肉,21例为腺肌瘤型息肉,7例为萎缩型息肉。结论检查时机不合适、息肉体积较小、宫内节育器影响、多次剖宫产、合并其他妇科疾病、未详细询问病史是导致经阴道三维超声漏诊误诊EP的主要因素。Objective To explore the reasons for missed diagnosis and misdiagnosis of endometrial polyp by transvaginal three-dimensional ultrasonography.Methods A total of 350 patients with abnormal uterine bleeding in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2021 were selected.Among them,227 patients with EP and 123 patients with non-EP were diagnosed by transvaginal three-dimensional ultrasound.Taking pathological results as the golden standard,the data of cases of missed diagnosis and misdiagnosis of EP by transvaginal three-dimensional ultrasound were retrospectively analyzed.Results The accuracy,misdiagnosis rate and missed diagnosis rate of transvaginal three-dimensional ultrasound in the diagnosis of EP were 72.57%(254/350),29.85%(20/67)and 26.86%(76/283),respectively.Among the 20 cases misdiagnosed as EP,there were 8 cases with benign endometrial hyperplasia,4 cases with submucosal myoma,3 cases with chronic endometritis,and 5 cases with normal proliferative/secretory endometrium.Among the 76 missed EP cases,there were 48 cases with hyperplastic polyps,21 cases with adenomyoma polyps and 7 cases with atrophic polyps.Conclusion The main causes of missed diagnosis and misdiagnosis of EP by transvaginal three-dimensional ultrasound are inappropriate examination time,small polyp volume,influence of IUD,multiple cesarean sections combination with other gynecological diseases and no detailed medical history.

关 键 词：子宫内膜息肉 经阴道三维超声 漏诊 误诊 

分 类 号：R711.74[医药卫生—妇产科学]