子宫内膜息肉的典型与非典型超声声像图特征分析

目的探讨超声检查子宫内膜息肉典型与非典型声像图特征及其漏误诊对策。方法收集经病理诊断为子宫内膜息肉的46例住院患者的资料,回顾性分析超声、临床及病理诊断结果。结果 (1)18例(39.1%)有典型超声声像图表现,超声为肯定性诊断,与病理诊断结果符合率达100.0%。声像图特征主要表现为:内膜区可见单或多发规则或不规则高回声灶。彩色多普勒血流显像(CDFI):>15 mm息肉可探及血流信号。(2)18例(39.1%)超声声像图不典型,超声为可能性诊断,与病例诊断结果符合率达100.0%。声像图表现:内膜(增厚或无增厚)回声不均匀;内膜呈蜂窝状改变;前后壁内膜厚度不同;宫腔较大占位病变(>20 mm);绝经期宫腔液性分离并高回声灶。(3)超声检查误漏诊占21.7%(10/46),表现为合并肌瘤内膜受压、宫腔息肉脱入宫颈内、经腹部超声漏诊、宫内节育环内膜显示欠佳、低年资缺乏经验漏诊。结论经阴道或腹部超声检查是子宫内膜息肉首选的最好的影像学诊断方法,特别是具有典型声像图和不典型声像图特征的子宫内膜息肉,有极其重要的临床应用价值。

Analysis of Typical and Atypical Sonographical Features in Endometrialpolyp

Objective To probe sonographic features of typical endometrialpolyp and atypical endometrialpolyp and to analyze countermeasures for missed diagnosis and misdiagnosis.Methods Clinical data of 41 patients diagnosed as endometrialpolyp were collected and pathological,clinical and ultrasound diagnosis results were retrospectively analyzed.Results(1) 18 cases(39.1%) had positive diagnosis with typical sonographic features,and the accordance rate was 100.0%.The sonographic features were:normal or proliferated hyper-echo lesions could be seen in endometrial location.Blood flow signal could be detected within endometrialpolyp.(2) 18 cases(39.1%) had probability diagnosis with atypical sonographic features,and the accordance rate was 100.0%.The sonographic features were:endometrium(with or without incrassation) had uneven echoes as well as faveolate changes,anterior and posterior endometrium had different wall thickness,uterine cavity had space occupying lesion(>20 mm),uterine cavity had fluid as well as high echo lesions.(3) Missed diagnosis and misdiagnosis by ultrasound accounted for 21.7%(10/46),mainly due to myoma,myoma prolapsing into the neck of uterus,abdominal ultradouns,uterine cavity contraceptive ring and lack of experience.Conclusion Transvaginal or abdominal ultrasound is a valuable imaging method for diagnosing endometrialpolyp,especially the endometrialpolyp with typical and atypical sonographic features.The method has great clinical application value.