腺性膀胱炎的超声漏、误诊原因分析

目的分析超声对腺性膀胱炎的误、漏诊原因,探讨减少其误、漏诊的方法。方法回顾性分析2006年1月2010年2月经病理证实的135例腺性膀胱炎的声像图表现。结果 135例腺性膀胱炎患者中,超声误诊26例,误诊率19.3%,漏诊11例,漏诊率8.2%。误诊的主要原因：乳头结节型和团块型与膀胱肿瘤声像图极为相似、容易混淆,超声医师对膀胱壁各层次的观察不仔细,对病史重视不够;漏诊的主要原因：膀胱充盈不佳或不充盈,病变体积太小、位于前壁或顶部,或病变位于膀胱后壁及颈部被明显增生的前列腺、膀胱内血凝块及膀胱结石等掩盖。结论超声是诊断腺性膀胱炎常用方法,但存在一定的误、漏诊,改进检查方法,可减少其误、漏诊发生。

Reasons of Missed Diagnosis and Misdiagnosis of Glandularis Cystitis by Ultrasonography

Objective To analyze the reasons of missed diagnosis and misdiagnosis of glandularis cystitis by ultrasonography. Methods The sonographic outcomes of 135 patients with glandular cystitis diagnosed by pathological examination from January 2006 to February 2010 were retrospectively analyzed. Results In 135 patients, misdiagnosis was in 26 with a rate of 19.3%, missed diagnosis was in 11 with a rate of 8.2%. The reasons of misdiagnosis included： the sonographic outcomes of mastoid and tuberculous conglomeration were similar to those of bladder tumour; the ultrasonographic professionals didn＇t clearly observe each layer of the bladder wall, and didn＇t pay enough attention to the disease history. The reasons of missed diagnosis included： the bladder was under-filled or unfilled, the size of the lesions were too small and were located at the anterior wall or the top, and the lesions were located at the posterior wall and neck of the bladder which were covered up by obvious prostate hyperplasia,and gores or stones of bladder so that the lesions could not be observed. Conclusion Ultrasonography is a usual method for diagnosing glandular cystitis,and we should ameliorate the examination to decrease the misdiagnosis and missed diagnosis.