卵巢畸胎瘤的二维超声诊断分析

Diagnosis of ovarian teratomas with two-dimensional ultrasound

目的 :探讨二维超声对卵巢畸胎瘤的诊断价值。方法 :回顾分析 2 78例经住院手术病理证实的卵巢畸胎瘤患者二维超声检查结果。结果 :2 78例卵巢畸胎瘤患者中良性畸胎瘤占 95 .3% (2 6 5 / 2 78) ,恶性畸胎瘤占 4 .7%(13/ 2 78) ;单侧病变占 88.5 % (2 4 6 / 2 78) ,双侧病变占 11.5 % (32 / 2 78)。术前超声诊断完全符合率为 95 .0 % (2 6 4 /2 78) ,误诊率为 3.6 % (10 / 2 78) ,漏诊率 1.4 % (4 / 2 78)。良性畸胎瘤诊断符合率为 95 .1% (2 5 2 / 2 6 5 ) ,误诊率为 3.4 %(9/ 2 6 5 ) ,漏诊率为 1.5 % (4 / 2 6 5 )。恶性畸胎瘤诊断符合率为 92 .3% (12 / 13) ,误诊率为 7.7% (1/ 13)。结论 :卵巢畸胎瘤二维超声检查有其特征性声像 ,是诊断卵巢畸胎瘤的首选方法 ,但还应注意与卵巢其它肿瘤、卵巢巧克力囊肿、浆膜下肌瘤变性、炎性包块等相鉴别。

Objective To investigate the value of two-dimensional ultrasound in the diagnosis of tertoma in the ovary.Methods The sonographic images of 278 cases of ovarian teratomas confirmed by surgical pathology were reviewed.Results According to the surgical pathological results of the 278 cases, 95.3%(265/278)were benign, and 4.7%(13/278)were malignant. Among those, 88.5% (246/278) cases were unilateral, and 11.5%(32/278)were bilateral. Compared with the surgical pathological results , the rate of accurate diagnosis with ultrasound was 95.0%(264/278), the rate of misdiagnosis was 3.6%(10/278), and the rate of missed diagnosis was 1.4%(4/278). Among the benign cases, the rate of accurate dingnosis was 95.1% (252/265); the rate of misdiagnosis was 3.4% (9/265) ; and the rate of missed diagnosis was 1.5% (4/265). Among the 13 malignant cases, the rate of accurate diagnosis and misdiagnosis were 92.3% (12/13) and 7.7% (1/13), respectively.Conclusion Two-dimensional ultrasound can be the first choice in diagnosing teratoma. Although the sonographic images of ovarian teratoma have specialities, they should be differentiated from other ovarian tumors, such as chocolate cyst of ovary, denaturation of subserous myoma, inflammatory mass, and etc.