|国家科技期刊平台
首页|期刊导航|临床误诊误治|女性盆腔非生殖系统肿物超声误诊分析

女性盆腔非生殖系统肿物超声误诊分析OACSTPCD

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

中文摘要英文摘要

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,the patient's condition was stable and no recurrence was reported.Conclusion The sources of non-reproductive system tumors in the fe-male pelvis are complex,and the ultrasonographic manifestations are diverse and atypical.In diagnosis,sonographers should pay attention to the comprehensive scan and detailed observation of pelvic masses in combination with the results of clinical and other imaging examinations,carefully determine the source and benign and malignant tumors,and finally make a definite diag-nosis through pathological examination.

杨珊燕;莫从辉

410035 长沙,长沙市第三医院超声诊断科410005 长沙,长沙市第一医院放射科

临床医学

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

Non-reproductive system tumors in the pelvisFemaleUltrasound examinationAngiomyolipomaMu-cinous cystadenocarcinomaRetroperitoneal neurinemomaPelvic tuberculosisMisdiagnosisOvarian tumor

《临床误诊误治》 2024 (014)

14-17 / 4

长沙市自然科学基金(kq2208461)

10.3969/j.issn.1002-3429.2024.14.004

评论