盆腔脂肪增多症误诊分析(附4例报告)

The misdiagnosis of pelvic lipomatosis(report of 4 cases)

目的分析盆腔脂肪增多症误诊原因,探讨盆腔脂肪增多症的诊断方法。方法回顾性分析4例盆腔脂肪增多症误诊、误治的临床资料。结果肛门指诊提示前列腺抬高;X线平片示盆部透亮度增加,静脉肾盂造影示输尿管扩张移位、肾盂积水;B超检查示盆腔内大量强回声光团,膀胱变形,肾盂、输尿管扩张;MRI检查示盆腔内大量短T1、短T2信号,膀胱变形并肾盂、输尿管扩张;CT检查示盆腔内大量低密度影并膀胱变形,输尿管及肾盂扩张。结论患者具有排尿困难症状,合并双肾积水时应考虑本病,并进行相应检查;肛门指诊、膀胱镜检查及经静脉尿路造影术(IVU)、MRI等影像学检查有重要意义。

Objective To analyse the cause of misdiagnosis of four cases suffering from pelvic lipomatosis in order for the to provide the measures diagnosis of typical Pelvic lipomatosis. Methods Clinical data of four cases suffering from pelvic lipomatosis were analysised retrospectively and all of them were followed. Results Several examination were performed in order to comfirm the diagnosis of pelvic lipomatosis.Drived up prostate could be detected by DRE.X-ray plain film only showed increased radioluentcy while IVU showed ureterectasis, ureteral displacement and hydronephrosis. Ultrasonography showed hyperechoic mass and bladder deformity in all patients, and pyeloureterectasis in all cases.MRI revealed massive short T1 and short T2 tissue in the pelvis, bladder deformity and pyeloureterectasis; CT demonstrated bladder deformity and massive lower density ( -86～-113HU) tissue in the pelvis and ureterectasis was revealed. Conclusions Some examination should be performed as the patient suffers from dysuria and twin-nephrolith.DRE?CT?MRI are the most important examination.