女性盆腔非生殖系统肿物超声误诊分析  

Analysis of Ultrasonic Misdiagnosis of Non⁃reproductive System Masses in the Female Pelvis

作　　者：杨珊燕 莫从辉 YANG Shanyan;MO Conghui(Department of Ultrasound Diagnosis,the Third Hospital of Changsha City,Changsha 410035,China;Department of Radiology,the First Hospital of Changsha City,Changsha 410005,China)

机构地区：[1]长沙市第三医院超声诊断科,长沙410035 [2]长沙市第一医院放射科,长沙410005

出　　处：《临床误诊误治》2024年第14期14-17,共4页Clinical Misdiagnosis & Mistherapy

基　　金：长沙市自然科学基金(kq2208461)。

摘　　要：目的探讨女性盆腔非生殖系统肿物患者的超声特征、误诊原因及防范误诊措施,以提高超声检查对女性盆腔非生殖系统肿物诊断的准确率,减少临床误诊误治的发生。方法对2020年4月至2023年5月收治的12例女性盆腔非生殖系统肿物超声误诊患者资料进行回顾分析。结果12例中以恶心、呕吐、腹胀、突发性右下腹痛为主要表现就诊1例,以发热、消瘦为主要表现就诊4例,以腰背痛、下肢麻木疼痛为主要表现就诊4例,以不规则阴道出血、发热、乏力、食欲缺乏、体质量减轻为主要表现就诊3例。行超声检查后初步诊断卵巢囊肿恶性变3例,后经病理检查诊断为子宫血管平滑肌脂肪瘤;初步诊断女性生殖系统肿瘤1例,后经病理检查诊断为阑尾低级别黏液性囊腺癌;初步诊断为子宫内膜异位囊肿4例,后经病理检查诊断为腹膜后神经鞘膜瘤囊性变;初步诊断卵巢癌4例,后经病理检查诊断为盆腔结核。3例子宫血管平滑肌脂肪瘤确诊后行肿瘤切除术治疗,1例阑尾低级别黏液性囊腺癌确诊后行阑尾切除术治疗,4例腹膜后神经鞘膜瘤囊性变确诊后行完全性手术切除,4例盆腔结核确诊后予足疗程、规范抗结核药物治疗。随访至今,患者病情稳定,未复发。结论女性盆腔非生殖系统肿物来源复杂,超声声像图表现多样且常不典型,超声医师应注意结合临床及其他影像学检查结果,并对盆腔肿物全面扫查及观察细节,仔细判断肿物的来源及良恶性,最后通过病理检查明确诊断。Objective To explore the ultrasonic characteristics,causes of misdiagnosis and preventive measures of non-reproductive system tumors in the female pelvis,so as to improve the accuracy of ultrasound diagnosis of non-reproductive system tumors in the female pelvis and reduce the occurrence of clinical misdiagnosis and mistreatment.Methods From April 2020 to May 2023,the data of 12 female patients with non-reproductive system tumors in the pelvis misdiagnosed by ul-trasound were retrospectively analyzed.Results Among the 12 patients,nausea,vomiting,abdominal distension and sudden right lower abdominal pain were the main manifestations in 1 patient,fever and wasting were the main manifestations in 4 pa-tients,low back pain and lower limb numbness and pain were the main manifestations in 4 patients,irregular vaginal bleed-ing,fever,fatigue,lack of appetite and loss of body mass were the main manifestations in 3 patients.After ultrasound exami-nation,3 patients were diagnosed with malignant ovarian cyst,and then diagnosed with uterine angiomyolipoma by pathological examination.The primary diagnosis of female reproductive system tumor was made in 1 patient,which was later diagnosed as low-grade mucinous cystadenocarcinoma of the appendix by pathological examination.The initial diagnosis was endometriosis cyst in 4 patients,and the pathological examination later confirmed retroperitoneal schwannoma with cystic degeneration.Ovarian cancer was initially diagnosed in 4 patients,and pelvic tuberculosis was diagnosed by pathological examination.Three patients with uterine angiomyolipoma were treated with tumor resection after diagnosis.One patient with low-grade mucinous cystadenocarcinoma of the appendix was treated with appendectomy after diagnosis,four patients with retroperitoneal schwan-noma and cystic degeneration were treated with complete surgical resection after diagnosis,and four patients with pelvic tuber-culosis were treated with full course of treatment and standard anti-tuberculosis drugs after diagnosis.To date

关 键 词：盆腔非生殖系统肿物 女性 超声检查 血管平滑肌脂肪瘤 黏液性囊腺癌 腹膜后神经鞘膜瘤 盆腔结核 误诊 卵巢肿瘤 

分 类 号：R733.5[医药卫生—肿瘤]