肾上腺肿瘤超声漏诊及误诊分析

Analysis of Ultrasonic Misdiagnosis and Missed Diagnosis of Adrenal Tumors

目的:通过超声对185例肾上腺肿瘤诊断及漏诊、误诊病例分析,寻找影响肾上腺肿瘤超声漏诊及误诊的因素。方法:本文回顾性分析185例肾上腺肿瘤超声与病理的资料,对超声漏诊和误诊原因进行了分类、归纳和总结。结果:通过185例肾上腺肿瘤的超声检查,超声诊断出肾上腺病变122例,诊断正确率65.95%,明显低于相关文献报道,漏诊57例,误诊6例。漏误诊率(34.05%),明显高于相关文献报道,综合分析其病理及影像学资料,将漏误诊原因归纳为五种:①左侧肾上腺肿瘤;②小于2.0 cm的肿瘤;③混合性回声的肿瘤;④临床及超声医师对肾上腺肿瘤认识不足;⑤误诊的主要原因是由于肿瘤巨大,造成定位困难。结论:通过对肾上腺肿瘤漏诊及误诊分析,可以提高超声诊断的准确性,降低漏误诊率。

Objective：To Search for the seasons ot the misagnosis and missed diagnosis of adrenal tumors by analyzing 185 ultrasonic misdiagnosis and missed diagnosis. Methods： The 185 cases of misdiagnosis and missed diagnosis of the adrenal tumors were retrospectively reviewed. The sonograms and the pathological data were recordes, and the reasons of misdiagnosis and missed diagnosis were classified. Results： Among the 185 cases, 122 cases found the lesions. The accuracy was 65.94%. 57 cases of misdiagnoses, 6 cases of missed diagnoses. The misdiagnosis and missed diagnosis rates （34. 06 %） are more than that of literatures reports. The misdiagnoses and missed diagnoses reasons were classified into five： ① parts ： the left adrenal glands tumors ; ② adrenal tumors less than 2 cm; ③ complex-echo tumors ; ④ignorance of the doctors when they had little knowledge about the disease; ⑤When the tumors were too large, the missed diagnoses happened. Conclusion： The analysis of the ultrasonic misdiagnosis and missed diagnosis of the adrenal tumors by ultrasound will increase the diagnostic accuracy and decrease the rate of the misdiagnosis and missed diagnosis.