摘要
目的探讨绒毛膜隆起超声声像图特征及误诊原因、防范措施。方法回顾性分析2012年6月—2020年12月收治的超声检查误诊经术后病理检查确诊绒毛膜隆起25例的临床资料。结果本组有生育史9例,其中2次及以上2例;有流产史9例,其中2次及以上4例;有清宫史7例,其中内膜息肉4例、内膜增厚2例、黏膜下肌瘤1例。25例首诊超声检查均误诊,误诊率100%,误诊为绒毛膜下血肿16例,部分性葡萄胎5例,胚胎停育4例。误诊时间3~7 d。本组均经术后病理检查确诊绒毛膜隆起。术后3个月随访,13例恢复良好,余失访;继续随访3年,再次妊娠4例,超声检查未发现异常,余均失访。结论绒毛膜隆起超声声像图具有一定特征性,特别是孕早期孕妇无明确阴道出血,而孕囊内出现附着于囊壁的结节样病灶时,应想到该病可能并加以鉴别,但其明确诊断依赖病理检查。
Objective To discuss characteristics of ultrasound image,misdiagnosed causes and preventive measures of chorionic bump.Methods A retrospective analysis was performed on clinical data of 25 patients with chorionic bump admitted between June 2012 and December 2020 who had been misdiagnosed by ultrasound examination and confirmed by postoperative pathological examinations.Results In this group,9 patients had childbearing history including 2 patients with childbearing for 2 times or more;9 patients had a history of miscarriage including 4 patients with miscarriage for 2 times or more;7 patients had a history of complete curettage of uterine cavity,which included 4 patients with endometrial polyps,2 patients with intimal thickening and 1 with submucosal fibroids.All the 25 patients were initially misdiagnosed by ultrasound examinations with a misdiagnosis rate of 100%.Among the patients,16 patients were misdiagnosed as having subchorionic hematoma,5 as having partial hydatidiform moles,and 4 as having arrested embryo.Misdiagnosed duration was 3 to 7 d.All patients in this group were confirmed as having chorionic bump by postoperative pathological examinations.During postoperative 3-months of follow-up,13 patients recovered well,and the remaining patients were lost to follow-up.They were followed up for consecutive 3 years,and 4 patients were pregnant again,and no abnormalities were detected by ultrasound examinations,and the remaining patients were lost to follow-up.Conclusion The ultrasound image of chorionic bumps has a certain characteristics,especially when there is no clear vaginal bleeding in the first trimester of pregnancy,and nodular lesions are attached to the gestational sac wall,and then chorionic bump should be considered and differentiated,abut definite diagnosis depends on pathological examinations.
作者
常俊杰
柏刚
张文君
CHANG Jun-jie;BAI Gang;ZHANG Wen-jun(Department of Ultrasonography,Taihe Hospital of Shiyan City Affiliated Hospital of Hubei University of Medicine,Shiyan,Hubei 442000,China)
出处
《临床误诊误治》
CAS
2021年第9期9-12,共4页
Clinical Misdiagnosis & Mistherapy
关键词
绒毛膜隆起
超声检查
误诊
绒毛膜下血肿
葡萄胎
胚胎停育
Chorionic bump
Ultrasonography
Misdiagnosis
Subchorionic hematoma
Hydatidiform mole
Arrested embryo
