Analysis of Ultrasonic Misdiagnosis of Atypical Uterine Adhesions
Objective To analyze the causes of ultrasonic misdiagnosis of atypical uterine adhesions and to improve the level of clinical diagnosis and treatment.Methods The clinical data of 40 patients with intrauterine adhesions treated from June 2021 to June 2023 were retrospectively analyzed.Results Among the 40 cases,18 cases of infertility were diag-nosed as chronic pelvic inflammatory disease and fallopian tube obstruction,and were still infertile after symptomatic treat-ment.9 cases of recurrent spontaneous abortion were admitted to hospital.12 cases were admitted to hospital with abnormal menstruation.After 5 days of symptomatic treatment in other hospitals,there was no improvement in 1 patient admitted to hos-pital.Transvaginal ultrasonography was performed in all 40 cases.The initial diagnosis was intrauterine adhesions in 23 cases,endometrial polyps in 1 case,endometrial cancer in 1 postmenopausal woman,and no uterine abnormalities in 15 cases.23 cases of intrauterine adhesions were preliminarily diagnosed by ultrasonography and separated by intrauterine adhesions.15 ca-ses of normal uterus were initially diagnosed by ultrasonography.Hysteroscopy was performed to confirm intrauterine adhesions and intrauterine adhesions separation.One case was initially diagnosed as endometrial polyp by ultrasound.Hysteroscopic ex-traction of endometrial polyp and submucous myoma combined with intrauterine adhesions was found,and intrauterine adhe-sions separation was performed.One case of postmenopausal woman was diagnosed as endometrial cancer by ultrasound,and confirmed as uterine adhesions and pyosis by hysteroscopy,and then underwent hysteroscopic cervical dilation.Among the 40 cases,16 cases were misdiagnosed and 1 case was missed.The misdiagnosis rate was42.50％(17/40),and the misdiagno-sis time was 3 d-8 years.After follow-up for 12 months,30 cases of symptoms disappeared or improved significantly,4 cases of symptoms did not improve significantly,6 cases of uterine adhesions recurred,and hysteroscopic adhesions separation was performed again.Conclusion Ultrasonic misdiagnosis rate of atypical intrauterine adhesions is high.For patients with uterine surgery and overdue menstruation,the possibility of intrauterine adhesions should be vigilant,and hysteroscopy should be rec-ommended as soon as possible for patients with suspected lesions to avoid misdiagnosis.
万方数据
维普
