子宫内膜间质肉瘤超声误诊12例原因分析

目的探讨子宫内膜间质肉瘤(endometrial stromal sarcoma,ESS)的超声声像图特点及误诊原因。方法回顾性分析12例经手术及病理证实的ESS的超声声像图表现。结果 12例术前均行彩色多普勒超声及频谱多普勒检查发现子宫或盆腔占位,肿瘤直径2.3~11.2 cm,收缩期流速峰值为(29±13.4)cm/s,阻力指数为(0.41±0.04)。超声检查均误诊,误诊为子宫肌瘤5例,子宫肉瘤、子宫内膜癌各2例,子宫腺肌症、子宫黏膜下肌瘤、盆腔肿块各1例。12例均经手术病理及免疫组织化学染色检查确诊ESS。结论应用二维超声与彩色多普勒血流显像相结合,有助于提高ESS的诊断正确率,减少误诊。

Misdiagnosis Analysis of 12 Patients with Endometrial Stromal Sarcoma by Ultrasound

Objective To explore the sonographic features and misdiagnosed causes of endometrial stromal sarcoma （ESS）.Methods Sonographic features of 12 patients diagnosed as having ESS by surgical means and pathology examinations,were retrospectively analyzed.Results Uterus or cavitas pelvis masses were found in 12 patients by preoperative Color doppler flow imaging and spectral doppler examination.Diameters of tumors were 2.3cm-11.2cm,peak systolic velocity （PSV） was （29 ± 13.4） cm/s,and resistance index （RI） was 0.41 ± 0.04.All the patients were misdiagnosed by ultrasound,5 patients were misdiagnosed as having uterine myoma,uterine sarcoma and endometrial carcinoma were respectively misdiagnosed in 2 patients,adenomyosis,submucous myoma and pelvic mass each were respectively misdiagnosed in 1 patient.All the patients were confirmed with having ESS by results of surgical pathology and immunohistochemical staining.Conclusion Two-dimensional ultrasound combined with color doppler is helpful in improving the diagnosis rate of ESS and avoiding misdiagnosis.