妊娠期附件区包块所致急腹症的超声成像评估

Ultrasound Evaluation of Acute Abdomen Caused by Adnexal Masses during Pregnancy

目的探讨妊娠期附件区包块所致急腹症的超声声像图表现及其诊断价值。方法以术中所见和病理诊断为金标准,对海南医学院第一附属医院2002年11月至2019年6月收治的26例妊娠期附件区包块所致急腹症患者的超声声像表现、手术治疗及妊娠结局进行回顾性分析。结果26例患者附件区包块超声定位诊断准确率为96.1%(25/26),超声诊断结果与术中所见及病理诊断结果比较准确率为57.7%(15/26);26例患者术中所见附件区包块扭转18例,超声诊断9例,准确率为50.0%。26例患者手术治疗后流产1例(3.8%)、未产23例(88.5%),顺产后手术治疗1例(3.8%),剖宫产并附件区包块切除术1例(3.8%)。结论超声检查能及时发现妊娠期附件区包块所致急腹症的病变并进行定位诊断,但对病灶病理性质诊断价值有限。

Objective To investigate the ultrasonographic features of acute abdomen caused by adnexal masses during pregnancy and the diagnostic value of ultrasound evaluation.Methods Data of 26 patients treated in the First Affiliated Hospital of Hainan Medical University between November 2002 to June 2019 for acute abdomen caused by adnexal masses during pregnancy were reviewed retrospectively.The ultrasonic features,surgical treatment and pregnancy outcome were analyzed using intraoperative and pathological findings as the gold standard.Results The accuracy rate was 96.1%(25/26)by ultrasonic localization,and 57.7%(15/26)among ultrasonic results,intraoperative findings and pathological diagnosis.Among the 18 cases of adnexal mass torsion confirmed by surgery,9 were diagnosed by ultrasound.The accuracy of ultrasound diagnosis of adnexal mass torsion was 50.0%.Of the 26 patients,1(3.8%)underwent abortion after operation,23(88.5%)had continuous pregnancy,1(3.8%)received surgical treatment after natural delivery,and 1(3.8%)underwent cesarean section combined with adnexal mass resection.Conclusion The ultrasound can promptly detect the lesions of acute abdomen caused by adnexal masses during pregnancy and their location,but has limited value for pathological diagnosis.