目的 对女性低位肠道肿瘤的超声误诊原因进行分析,以提高术前定位诊断水平。方法 回顾性分析拟诊盆腔肿块收入妇产科、经手术病理证实为肠道肿瘤的18例患者的资料,针对术前超声误诊原因进行分析。结果 术前超声提示12例肿瘤为妇科来源,6例未提示来源。15例肿块呈囊实性混合回声,2例呈低回声,1例呈无回声。术中探查发现,所有患者的肿块均来自小肠,即与外科医师配合行小肠肿物切除术,术后病理检查结果提示为小肠间质瘤16例,小肠平滑肌瘤1例,肠重复畸形1例。结论 女性复杂盆腔肿块有肠道来源可能,易误诊为子宫附件来源肿瘤,需着重扫查肿块与子宫附件间的关系及血供来源,超声检查可作为鉴别首选。
Objective: To analyze the causes of ultrasound misdiagnosis of low position intestinal tumor in female patients for improving the preoperative diagnosis. Method: To review and analyze eighteen women with surgically and pathologically proved low position intestinal tumor who had been misdiagnosed as gynecologic tumor preoperatively by ultrasonography between 2008 and 2015.The causes of misdiagnosis were analyzed. Result: Imaging of preoperative ultrasonography denoted as gynecological tumor in 12 cases and did not reveal the source in other 6 cases. The mass was of cystic and solid echo in fifteen cases, hypoechoic in two cases, and anechoic in one case. Operative exploration revealed that the mass was from small intestine in all the cases and hence resection of the small intestine tumor was conducted. Pathological findings showed that 16 cases were small intestinal stromal tumor, one was small intestinal leiomyoma and one was intestinal deformity. Conclusions: Low position intestinal tumor in women are often misdiagnosed as uterine appendage tumor. Ultrasound is a preferred approach of examination, and special focus should be paid on the identification of blood supply and the relationship between the tumor and uterine appendage.
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