子宫肌瘤的超声诊断与鉴别诊断

目的：探讨子宫肌瘤的声像图特征以及诊断与鉴别诊断,以提高诊断准确率。方法：对上海中山医院青浦分院采用Acuson超声诊断仪2009～2011年诊断的213例子宫肌瘤（经腹部探测）,进行对病灶的部位、大小、形态、回声特征的监测及部分患者术后的随访观察。结果：213例患者中肌壁间肌瘤128例,浆膜下肌瘤56例,黏膜下肌瘤10例,混合性肌瘤19例。经随访,手术治疗的78例,其中病理符合76例、符合率达到97.4%左右,1例误诊（病理为子宫肌腺症）、1例漏诊（病理为妊娠合并肌瘤）,误诊率为1.3%。结论：超声可动态观察子宫肌瘤的声像图特征,具有方便快捷、误诊率低、无创伤等特点,是临床首选检查,在子宫肌瘤的诊断、治疗及术后随访方面起着相当重要的作用。

The diagnosis and differential diagnosis of hysteromyoma by ultrasound

Objective： To explore the hysteromyoma uhrasonographic feature and the diagnosis and difterential diagnosis, in order to improve the diagnostic accuracy. Methods： 213 cases of hysteromyoma diagnosis in Shanghai Zhongshan Qing-pu Affiliated hospital were chosen and were diagnosed,by the ultrasonic diagnostic instrument acuson during 2009-2011 （detection through the abdomen）, the focus position, size, shape, echo characteristics were monitored and some patients were followed up. ]Results： Among 213 cases, muscle intramural fibroids 128 cases, subserosal fibroids 56 cases, submu- cosal fibroids 10 cases, mixed fibroids 19 cases. The surgical treatment of 78 patients, pathology were 76 cases, the coinci- dence rate was 97.4%, and 1 case was misdiagnosed （pathological for abenomyosis）, 1 case was missed diagnosis （pathologi- cal for pregnancy with fibroids）, the misdiagnosis rate was 1.3%. Conclusion： Dynamic ultrasound can observe the hys- teromyoma ultrasonographic feature, with convenient and quick, low misdiagnosis rate, no wound, it is the best choice of clinical examination, it plays a very important roleuterine in fibroids diagnosis, treatment and postoperative follow-up.