经阴道彩超对附件脓肿的诊断价值

The value of transvaginal color Doppler ultrasonography in diagnosis of accessory abscess

目的探讨附件脓肿的临床及声像图特征,以提高超声诊断率。方法选取2018年1月~2020年05月在成都市第一人民医院经手术病理证实为附件脓肿的104例患者为研究对象,对患者术前经阴道彩超的声像图特征进行回顾性分析,评价经阴道彩超对附件脓肿的诊断及鉴别诊断价值,并总结分析漏、误诊原因。结果104例患者中,术前超声正确诊断86例(82.7%),误诊10例(9.6%),漏诊8例(7.7%)。104例患者中56例为双侧发病,48例为单侧发病,共计160个病灶。其中95个病灶为输卵管脓肿,65个病灶为输卵管卵巢脓肿。160个病灶的声像图特征大致分为3种类型:囊性病灶79个,囊实混合回声性病灶52个,实性病灶29个。结论经阴道彩超诊断附件脓肿操作简便、快捷、掌握其声像图特征及鉴别诊断,结合临床表现及实验室检查可提高临床诊断准确性。

Objective To explore the sonographic features of accessory abscess and improve the coincidence rate of ultrasonic diagnosis.Methods 104 patients with accessory abscess confirmed by surgery and pathology in our hospital from January 2018 to May 2020 were selected for a retrospective analysis of the preoperative characteristics of transvaginal ultrasonography.The diagnostic value of transvaginal color Doppler ultrasound in pelvic inflammatory disease-accessory abscess were evaluated.The causes of misdiagnosis and differential diagnosis were summarized and analyzed.Results Among the 104 cases,86 cases were diagnosed correctly by preoperative ultrasound,with a diagnosis coincidence rate of 82.7%,and 10 cases were misdiagnosed(9.6%).Eight cases were missed(7.7%).Among the 104 patients,56 had bilateral lesions and 48 had unilateral lesions,with a total of 160 lesions.Among them,there were 95 lesions of pyosalpinx and 65 lesions of tubo-ovarian abscess(TOA).The 160 lesions were divided into 3 types according to the sonographic features inclcudeing 79 cases of cystic lesions,52 cases of cystic and solid mixed echogenic lesions and 29 cases of solid lesions.Conclusion Transvaginal color Doppler ultrasonography in the diagnosis of pelvic inflammatory disease-accessory abscess is easy and fast to operate.Mastering its sonographic features and differential diagnosis,combining the clinical manifestations and laboratory examination can improve the accuracy of clinical diagnosis.