超声诊断剖宫产术后腹壁切口子宫内膜异位症价值

Value of ultrasonography to the diagnosis of abdominal wall endometriosis after cesarean section

目的总结剖宫产术后腹壁切口子宫内膜异位症(abdominal wall endometriosis,AWE)的超声表现,进一步提高AWE的诊断准确率。方法回顾性分析21例AWE患者的超声声像资料。结果 AWE肿块可位于皮下脂肪层、脂肪层与腹直肌前鞘之间及腹直肌内,形态不规则,边界不清,无包膜,呈不均质中低回声;经期肿块回声略低,并可见多个小液性暗区;肿块大小及内部回声可随月经周期发生动态变化;彩色多普勒显示17例肿块内无血流信号,4例可见星点状、短棒状或条束状彩色血流信号;频谱多普勒显示为低速高阻型的动脉血流频谱。结论根据AWE典型超声声像图表现,结合患者剖宫产病史和临床表现,可明确AWE诊断。

Objective To summarize the ultrasonic manifestations of abdominal wall endometriosis （AWE） after caesarean section in order to improve its diagnostic accuracy. Methods The ultrasonic images were retrospectively analyzed in 21 patients with AWE. Results AWE mass was located in subcutaneous adipose layer, between subcutaneous adipose layer and rectus abdominis anterior sheath, or in rectus abdominis, in irregular shape, with obscure boundary, no capsule, and inhomogeneous low signal intensity. Menstrual masses echo was slightly lower and there were more small liquid dark areas. The tumor size and inner echo changed with menstrual cycle. Color Doppler showed no blood flow signal in 17 cases of tumor, and 4 cases were found star point, short rod-like or cord-like color flow signal. Spectral Doppler displayed low-speed and high-resistance artery blood flow spectrum. Conclusions AWE diagnosis can be made on the basis of typical ultrasonic features, cesarean section history and clinical manifestations.