盆腔子宫内膜异位症患者CT影像学表现及误诊分析
CT Imaging Findings and Misdiagnosis of Patients with Pelvic Endometrio-sis
宋宝玉 1徐斌2
作者信息
- 1. 100006 北京,首都医科大学附属北京妇产医院药事部
- 2. 100006 北京,首都医科大学附属北京妇产医院放射科
- 折叠
摘要
目的 分析盆腔子宫内膜异位症的临床、CT影像学表现和误诊原因、防范措施.方法 回顾性分析2020 年1 月—2022 年2 月收治的就诊初期误诊为卵巢功能性囊肿、囊腺瘤的盆腔子宫内膜异位症14 例的临床资料.结果 14 例均于左下腹触及较大包块,月经紊乱10 例,性交痛7 例,痛经6 例,低热2 例;14 例查血白细胞计数、C反应蛋白轻度升高各2 例,血红蛋白均降低,癌抗原125 轻度升高5 例.行CT检查等后初步诊断为卵巢功能性囊肿11例、囊腺瘤3 例.误诊时间2～3d.14 例均行腹腔镜手术治疗,术中病理检查确诊为盆腔子宫内膜异位症.遂行腹腔镜下异位病灶切除术,术后随访1 年均无复发.结论 盆腔子宫内膜异位症早期症状常不典型,易误诊.加强对该病的认识,对以下腹痛、月经紊乱、性交痛、盆腔包块为主要症状就诊者,应仔细鉴别诊断,当CT检查不能明确诊断时及时行腹腔镜手术病理检查,以及早诊断并治疗.
Abstract
Objective To analyze the clinical and CT imaging manifestations,causes of misdiagnosis and preventive measures of pelvic endometriosis(PE).Methods The clinical data of 14 patients with PE who were initially misdiagnosed as functional ovarian cyst and cystadenoma from January 2020 to February 2022 were retrospectively analyzed.Results All the 14 cases had large mass in the left lower abdomen,including menstrual disorder in 10 cases,dyspareunia in 7 cases,dysmen-orrhea in 6 cases,and low fever in 2 cases.In 14 cases,white blood cell(WBC)count,C reactive protein(CRP)slightly increased in 2 cases respectively,hemoglobin decreased,and cancer antigen 125 slightly increased in 5 cases.After CT exam-ination,the preliminary diagnosis was ovarian functional cyst in 11 cases and cystadenoma in 3 cases.The duration of misdi-agnosis was 2-3 d.All the 14 cases underwent laparoscopic surgery and were diagnosed as pelvic endometriosis by pathological examination.Laparoscopic ectopic lesion resection was performed,and no recurrence was observed at 1-year follow-up.Con-clusion The early symptoms of PE are often atypical,and are more likely to cause misdiagnosis.To strengthen the under-standing of this disease,patients with abdominal pain,menstrual disorder,dyspareunia,and pelvic mass as the main symp-toms should be carefully differentiated and diagnosed,and timely laparoscopic pathological examination,as well as early diag-nosis and treatment should be performed when CT examination fails to make a clear diagnosis.
关键词
子宫内膜异位症/误诊/卵巢功能性囊肿/囊腺瘤/癌抗原125/腹腔镜检查/病理学/体层摄影术,螺旋计算机Key words
Endometriosis/Misdiagnosis/Functional ovarian cyst/Cystadenoma/Cancer antigen 125/Laparoscopy/Pathology/Tomography,spiral computed引用本文复制引用
出版年
2023
国家科技期刊平台
NSTL
万方数据