摘要
目的探讨子宫内膜息肉经阴道彩超影像特征,总结误诊原因及防范措施。方法回顾性分析2021年1月至2024年1月收治的经阴道彩超误诊的3例子宫内膜息肉患者的临床资料。结果3例中,1例因月经量增多并经期延长6个月就诊,初次经阴道彩超检查显示宫腔内低回声团块,误诊为子宫黏膜下肌瘤;1例因育龄期不孕2年伴月经周期不规律就诊,初次经阴道彩超检查显示宫腔内中等回声团块,伴有少量血流信号,误诊为子宫黏膜下肌瘤;1例因绝经后不规则阴道出血伴轻微下腹疼痛3个月就诊,初次经阴道彩超检查显示宫腔内低回声团块,边界不清,误诊为早期子宫内膜癌。3例进一步完善宫腔镜检查见宫腔内病变呈息肉样病变,病理结果提示子宫内膜息肉,修正诊断为子宫内膜息肉。误诊时间为1~3个月。确诊后行宫腔镜下息肉切除术,术后随访3个月,未出现复发,预后良好。结论子宫内膜息肉缺乏典型的临床表现,经阴道彩超虽是常用的初步筛查手段,但其特异性有限,容易导致误诊。临床医师需加强对就诊患者临床表现的综合评估并完善相关检查,强化对子宫病变的鉴别诊断,以提高诊断的准确性。
Objective To investigate the imaging characteristics of endometrial polyps on transvaginal color Doppler ultrasound,and to summarize the causes of misdiagnosis and preventive measures.Methods The clinical data of 3 patients with endometrial polyps misdiagnosed by transvaginal color Doppler ultrasound from January 2021 to January 2024 were retrospectively analyzed.Results Among the 3 patients,1 patient visited the hospital due to increased menstrual volume and prolonged menstrual period for 6 months.The initial transvaginal color Doppler ultrasound examination showed a hypoechoic mass in the uterine cavity,which was misdiagnosed as submucosal uterine fibroid.One patient presented with infertility in childbearing age for 2 years and irregular menstrual cycle.The initial transvaginal color Doppler ultrasound examination showed a moderately echogenic mass in the uterine cavity with a small amount of blood flow signals,which was misdiagnosed as submucosal uterine fibroid.One patient presented with postmenopausal irregular vaginal bleeding and mild lower abdominal pain for 3 months.The initial transvaginal color Doppler ultrasound examination showed a hypoechoic mass in the uterine cavity with unclear boundaries,which was misdiagnosed as early endometrial cancer.Hysteroscopy showed that the lesions in the uterine cavity were polypoid lesions in 3 patients,and the pathological results suggested endometrial polyps;therefore the diagnosis was revised as endometrial polyps.The misdiagnosis lasted 1 to 3 months.Hysteroscopic polypectomy was performed after diagnosis,and the pathological results were benign.No recurrence occurred during the 3-month follow-up,and the prognosis was good.Conclusion Endometrial polyps lack typical clinical manifestations.Although transvaginal color Doppler ultrasound is commonly used as a preliminary screening method,its specificity is limited,which is more likely to lead to misdiagnosis.Clinicians need to strengthen the comprehensive evaluation of the clinical manifestations of patients,perform the relevant examinations,and strengthen the differential diagnosis of uterine lesions to improve the accuracy of diagnosis.
作者
李颖
李朝玉
文丽君
张钰娸
姚茂碧
LI Ying;LI Chaoyu;WEN Lijun;ZHANG Yuqi;YAO Maobi(Department of Ultrasound,the Second People's Hospital of Neijiang City,Neijiang,Sichuan 641000,China;Department of Anesthesiology,the Second People's Hospital of Neijiang City,Neijiang,Sichuan 641000,China)
出处
《临床误诊误治》
2025年第24期7-14,共8页
Clinical Misdiagnosis & Mistherapy
基金
四川省卫生健康科研课题立项项目(20PJ291)。
关键词
子宫内膜息肉
经阴道彩超
误诊
子宫黏膜下肌瘤
子宫内膜癌
宫腔镜
病理检查
endometrial polyp
transvaginal color ultrasound
misdiagnosis
submucosal uterine fibroid
endometrial carcinoma
hysteroscopy
pathological examination
