盆腔肿物彩色多普勒超声误诊分析

摘要

Objective To explore the reasons for mistaken diagnosis of pelvic mass using color Doppler ulstrasound in order to improve the accuracy of the mass diagnosis. Methods The features of ultrasonography and clinical data of 34 cases which were mistakenly diagnosed as pelvic mass were retrospectively analyzed and compared with other imaging data or clinical operation pathology. Results Four cases of pelvic abscess were mistakenly diagnosed as ovarian cancer, two cases of ovarian cancer were mistakenly diagnosed as pelvic abscess, and other four cases of ovarian cancer were mistakenly diagnosed as teratoma or subserous myoma. Two cases of old ectopic pregnancy were mistakenly diagnosed as subserous myoma and four cases of old ectopic pregnancy were mistakenly diagnosed as inflammation mass. Eight cases of corpus luteum menstmationis were mistakenly diagnosed as ascoma. Two cases of appendix mucus cystoadenoma were mistakenly diagnosed as ovarian cyst. One case of mesenterium lymphadentis was mistakenly diagnosed as perforation of uterus. One case of megaloureter was mistakenly diagnosed as ovarian cyst. One case of teratoma with pelvic cavity was mistakenly diagnosed as chocolate cyst. Three cases of retroperitoneal tumours were mistakenly diagnosed as pelvic cyst or solid turner. One cervix cyst was mistakenly diagnosed as adnexa cyst. One mature teratoma torsion of left ovary was mistakenly diagnosed as right. Conclusions Lack of experience is the main reason for mistaken diagnosis of pelvic mass. The untypical or unusual diseases are also subject to mistaken diagnosis. Grasping the clinical situation and features of pathological changes and combining with the features of ultrasonography of different disease can help improve the accuracy of diagnosis.%目的 探讨盆腔肿物彩色多普勒超声误诊原因,以提高盆腔肿物的超声诊断准确率.方法 回顾性分析34例盆腔肿物超声误诊病例的临床资料及超声声像图特点,并与其他影像学资料或临床手术病理结果对照.结果 盆腔脓肿误诊为卵巢癌4例;卵巢癌误诊为盆腔脓肿2例,误诊为畸胎瘤2例,误诊为浆膜下肌瘤2例;陈旧性宫外孕误诊为浆膜下肌瘤2例,误诊为盆腔炎性包块4例;月经黄体误诊为卵巢囊实性或实性肿物8例;阑尾黏液性囊腺瘤误诊为卵巢囊肿2例;肠系膜淋巴结炎误诊为子宫穿孔1例;巨输尿管误诊为卵巢囊肿1例;盆底直肠前壁畸胎瘤误诊为巧克力囊肿1例;腹膜后肿瘤误诊为附件囊实性包块3例;宫颈多发潴留样囊肿误为附件囊肿1例;左卵巢成熟畸胎瘤扭转误诊为右侧肿物扭转1例.结论 临床经验不足是盆腔常见病误诊的主要原因,病变不典型及少见病易误诊.掌握盆腔病变的临床表现、病理特征,结合不同病变的超声声像图特点,能提高诊断准确率.