阑尾粘液性肿瘤超声误诊分析

目的 探讨阑尾粘液性肿瘤超声误诊的原因。方法 回顾性分析 2014 年 4 月-2018 年 4 月在我院就诊的经术后病理证实的 13 例阑尾粘液性肿瘤患者 的超声声像图表现。结果 13 例患者中，二维超声声像图特征分别为：4 例表现 为盆腹腔内巨大低回声肿块伴腹腔积液；1 例表现为右侧附件区无回声，张力差； 5 例表现为右侧附件区以囊性为主的混合回声；3 例表现为典型的右下腹阑尾区 肿大的具有盲端的低回声管状结构伴周围少许无回声区。超声诊断分别为：9 例 患者诊断为卵巢来源的恶性肿瘤；1 例患者诊断为输卵管来源的囊性肿物；3 例 患者诊断为急性阑尾炎并周围渗出。结论 阑尾粘液性肿瘤为临床罕见病。超声 声像图表现不典型。当病变体积较大时，超声难以准确定位，极难与右侧卵巢及 输卵管来源的肿瘤相鉴别。而对于病变体积相对较小的患者，虽然超声能够相对 准确的定位病变来源，但因超声声像图表现与阑尾的炎症性改变相重叠，极易误 诊为阑尾炎。故而，对于超声不能准确定位以及超声怀疑阑尾炎的患者，其他的 影像学诊断可以作为一种补充。

Misdiagnosis of mucinous tumor of appendix by ultrasonography

Objective: To investigate the cause of misdiagnosis of mucinous tumor of appendix by ultrasonography.Methods:The ultrasonographic findings of 13 patients with mucinous tumor of the appendix who were treated in our hospital from April 2014 to April 2018 were retrospectively analyzed.Results:Among the 13 patients, the characteristics of two-dimensional ultrasonography were as follows: 4 patients, the characteristics of two-dimensional ultrasonography were as follows: 4patient presented with massive hypoechoic mass in peritoneal cavity with abdominal effusion. 1 case showed no echo in the right accessory area and poor tension. 5 cases showed mixed echo dominated by cystic in the right accessory area. 3 case presented as a typical case of right lower quadrant appendiceal enlargement with a blind hypoechoic tubular structure with a few anechoic areas around. The ultrasonographic diagnosis was as follows: 9 patients were diagnosed as malignant tumors of ovarian origin; 1 patient was diagnosed as a cystic mass of oviduct origin. 3 patient was diagnosed with acute appendicitis and had peripheral exudation.Conclusions: Appendiceal mucinous tumor is a rare disease. Ultrasonic sonogram is not typical. When the lesion size is large, ultrasound is difficult to accurately locate, and it is extremely difficult to differentiate from tumors of the right ovary and oviduct origin. For patients with relatively small size of lesions, although ultrasound can relatively accurately locate the source of lesions, it is easy to be misdiagnosed as appendicitis due to the overlapping of ultrasonography and inflammatory changes in the appendix. Therefore, other imaging diagnosis can be used as a supplement for the patients whose ultrasound cannot accurately locate and suspected appendicitis