彩色多普勒高频超声对腹壁子宫内膜异位症的诊断价值研究

Diagnosic evaluation study of color doppler ultrasonic examination in abdominal wall endometriosis

目的：探讨腹壁子宫内膜异位症的彩色多普勒高频超声表现，评价其临床应用价值。方法回顾性分析2010年2月至2013年12月，山东省聊城市人民医院经手术病理证实的腹壁子宫内膜异位症患者36例的高频超声二维图像及彩色多普勒超声表现。结果36例腹壁子宫内膜异位症患者中，位于脂肪层内16例，位于肌层内20例，直径1．1∽5．2 cm。二维超声表现：无包膜，形态不规则，边缘不光滑，内部为不均质低回声，随月经的不同时期肿块大小及回声呈相应改变。彩色多普勒超声显示病灶内部可见点状或条状血流信号，其动脉均为低速高阻频谱。超声诊断的准确率为83．3％，误诊率为16．7％。结论彩色多普勒高频超声可直接显示腹壁子宫内膜异位症病灶的大小形态、内部回声及血供情况，可作为诊断腹壁子宫内膜异位症的首选影像学检查方法。

Objective To explore the color doppler ultrasound manifestation of abdominal wall endometriosis,and evaluate its clinical value. Methods The manifestation of two-dimensional high frequency ultrasonography and color doppler imaging of 36 patients withabdominal wall endometriosis,which proven by surgery and pathology,were retrospectively analyzed.Results Among the 36 patients with abdominal wall endometriosis,1 6 cases located in fat layer,20 cases in muscular layer,with diameter ranging from 1 .1 to 5 .2 cm.With two-dimensionalultrasonography,there was no capsule,but with irregular morphology,blurred margins,low echoes inside and some parts of irregular no-echo areas.The size and internal echo of the mass changed respectively according to the menstruation.Color doppler ultrasound showed scattered or striped flow signals in the lesion,whose artery displayed low-speed and high resistance frequency spectrum.The accuracy and misdiagnosis rate of ultrasonography were 83.3% and 1 6.7%, respectively.Conclusions The color doppler ultrasound may directlydisplay the size,morphology,condition of internal echo and blood inflow of the abdominal wall endometriosis lesion.Therefore,it is the first choice of imaging examination for the diagnosis of abdominal wall endometriosis.