腹膜后神经鞘瘤的超声诊断质量及其影响因素分析  

Quality of ultrasonic diagnosis of retroperitoneal schwannomas and its influencing factors

作　　者：武玺宁 张培培 齐振红 张璟[1] 赵瑞娜 孟华 李建初 Wu Xining;Zhang Peipei;Qi Zhenhong;Zhang Jing;Zhao Ruina;Meng Hua;Li Jianchu(Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,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

出　　处：《中华医学超声杂志（电子版）》2023年第7期701-704,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：2019年度北京协和医院青年基金(pumch201911591)。

摘　　要：目的评价腹膜后神经鞘瘤的超声诊断质量,分析其影响因素并探讨提高诊断质量的措施。方法以2015年1月至2022年4月于北京协和医院经手术治疗并病理诊断为腹膜后神经鞘瘤的患者为研究对象,总结术前超声检查结果,以定位诊断和定性诊断为指标评价超声诊断质量。结果有完整术前超声报告的腹膜后神经鞘瘤共21例,均为单发,1例(4.8%)超声检查漏诊。超声诊断的20例中,最大直径为(6.7±3.6)cm,16例(80.0%)位于腹部腹膜后,4例(20.0%)位于盆腔腹膜后;14例(70.0%)表现为混合回声的囊实性肿物,6例(30.0%)表现为低回声的实性肿物。20例超声报告中,17例(85.0%)定位诊断符合,3例(15.0%)定位诊断不符合。2例(10.0%)定性诊断符合,18例(90.0%)定性诊断不符合。结论腹膜后神经鞘瘤的超声定位诊断准确率高。腹膜后神经鞘瘤缺乏典型超声声像图特征,超声医师应熟悉解剖并重视病史采集,进一步提高其定性诊断的准确性。Objective To evaluate the quality of ultrasonic diagnosis of retroperitoneal schwannomas and its influencing factors to find the measures to improve the diagnosis quality.Methods From January 2015 to April 2022,patients with retroperitoneal schwannomas who underwent surgery at Peking Union Medical College Hospital were studied.All of the cases were confirmed by pathology.The results of preoperative ultrasound reports were summarized,and the quality of ultrasound diagnosis was evaluated by localization diagnosis and qualitative diagnosis.Results There were 21 cases of retroperitoneal schwannomas with preoperative ultrasound report,all of them were single,and one case(4.8%)was missed by preoperative ultrasound.The maximal diameter of the 20 schwannomas diagnosed by preoperative ultrasound was(6.7±3.6)cm,of which 16(80.0%)were located in the abdominal retroperitoneum and 4(20.0%)were located in the pelvic retroperitoneum;14(70.0%)manifested as a heterogeneous solid and cystic mass,and 6(30.0%)presented as a hypoechoic solid mass.Among the 20 cases,17(85.0%)were in accordance with the localization diagnosis and 3(15.0%)were not;2(10.0%)were qualified for qualitative diagnosis and 18(90.0%)were not.Conclusion Ultrasound has a high accuracy for the localization diagnosis of retroperitoneal schwannomas.Retroperitoneal schwannomas lack typical sonogram characteristics,and sonographers should be familiar with the anatomy and pay attention to the medical history collection to further improve the accuracy of its qualitative diagnosis.

关 键 词：超声 腹膜后 神经鞘瘤 质量控制 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.61[医药卫生—诊断学]