腹壁子宫内膜异位症的高频超声表现及其诊断价值

High frequency ultrasound expression of abdominal wall endometriomas and diagnostic value

目的：探讨腹壁子宫内膜异位症的高频超声表现及其诊断价值。方法对32例经手术、病理证实的腹壁子宫内膜异位症的超声声像图进行回顾性分析。结果病灶共计33个，其中1例为多发（2个病灶），其余31例均为单发，大部分位于原腹壁切口处或切口旁皮下软组织内，1例远离切口，位于腹股沟区。位于皮下脂肪层内病灶26个，腹直肌内病灶6个。所有病灶形态不规则，无包膜，以不均质低回声为主，个别病灶内尚可见小片状无回声。 CDFI根据Adler半定量法分级，25个病灶为0级（无血流信号），7个病灶为I级（边缘有少量点状、短棒状血流信号），脉冲多普勒表现为低速高阻的特点。结论结合病史和临床表现，高频超声对腹壁子宫内膜异位症可以作出相对明确的诊断，对手术定位具有指导意义，可作为该疾病首选检查方法。

Objective To explore the character and clinical value of high frequency ultrasound in diagnosing abdominal wall endometriomas .Methods The characteristics of the ultrosonographic images in 32 cases with abdomi-nal wall endometriomas by operation and pathology were analyzed retrospectively .Results A total of 33 lesions, including 1 case of multiple （2 lesions）,the rest of the 31 cases were single,mostly in the original abdominal incision place or incision side subcutaneous soft tissue ,1 case away from the incision ,located in the inguinal region .26 lesions was located in the subcutaneous fat and 6 lesion in the rectus abdominis muscle .All of the lesions hadn＆#39;t capsule and were irregular in shape .The internal echo behaved low echo and on homogenous mostly ,one or more small anechoic lacunae could be seen on sonography .CDFI according to Adler semi -quantitative method classification ,25 lesions was 0 level （no blood flow signal）,7 lesions for I level （edge had a small amount of pitting,short rod blood flow signal）,Pulse doppler performance for low -speed and high-resistance characteristics.Conclusion Combining with the history and clinical performance , high frequency ultrasonography in abdominal wall endometriosis can be made relatively clear diagnosis,surgery of positioning has a guiding significance ,which can be used as the disease choice examination method.