脐尿管囊肿合并感染的超声误诊原因浅析

目的旨在探讨脐尿管囊肿合并感染的声像图规律,查找误诊原因,总结经验教训,提高诊断水平。方法追综观察14例脐尿管囊肿及其合并感染的声像图,并与手术结果对比观察。结果14例脐尿管囊肿及其合并感染的声像图特征。大体可分为(1)单纯囊肿型病灶位于脐下膀胱顶部上方,腹壁深层类圆形的囊状无回声,有上方指向脐部、下方指向膀胱区的2个开口。本组病例中3例符合此种声像图,超声诊断符合率100%;(2)囊肿合并感染时分下列3种类型1)病灶与膀胱前壁相连导致膀胱前壁局限性增厚;2)病灶穿透膀胱前壁与膀胱相通形成膀胱憩室;3)病灶与脐相连。本组11例合并感染病例,超声诊断符合率为27.3%,误诊率为72.7%。结论虽然超声对脐尿管囊肿的诊断有其局限性,但如果对其病灶声像图进行综合性分析,运用一定扫查技巧,可以在很大程度上降低误诊的可能性。

Urachal Cyst Complicated with Infection Misdiagnosed by Ultrasound

Objective To investigate the ultrasonographic characteristics of the urachal cyst complicated with infection,to find out the causes of misdiagnosis and to sum up the experience and lessons for improving the accuracy of diagnosis.Methods The ultrasonographic characteristics in the 14 patients compared with operation results.Results The ultrasonographic characteristics in 14 patients were as follows:1.Simple cystic type:the focus was round cyst without echoes between the umbilicus and the apex of the bladder.There were two hatches in the focus pointing to the bladder and umbilicus respectively.This type was found in 3 patients,and the accuracy diagnostic rate was 100%(3/3).2.The cysts complicated with infection can be divided into 3 types :(1) the connection of the focus with the front wall of the bladder partly incrassation in the front wall;(2)Focus penetrated the front bladder wall and connected with the bladder to form diverticulum;(3)Focus connected with umbilicus.This type was found in 11 patients,and the coincident diagnosis rate was 27.3%(3/11).Conclusions Although the ultrasonographic diagnosis of urachal cyst has its limit,general and comprehensive analysis with precise examination can improve the diagnostic accuracy rate.