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目的:分析我院1983年以来经临床诊断和病理证实的22例葡萄胎患者的超声诊断情况,总结声像图特异性改变和误诊原因,旨在提高对此病的超声诊断水平。方法:本组为我院就诊的患者;用日本产RT-2800超声仪,探头3.5MHz.适度充盈膀胱行超声检查。确诊为葡萄胎者,于二次及三次清宫前经超声引导并结合HCG测定。结果:20例符合为葡萄胎,超声表现为:宫内充满低至中等的点状、团状和横行的短条状回声,其间夹有许多散在透明的液性暗区,暗区可呈圆形、椭圆形、裂隙状和不规则形,并形成“蜂窝状”或“落雪样”异常结构,与宫壁分界清晰,边缘规整,有时伴环状低回声晕。7例于子宫单侧或双侧见黄素囊肿。本文根据葡萄胎内暗区的多少和大小分为小泡型、大泡型和非典型型。2例误诊,病理为过期流产。结论:诊断葡萄胎超声符合率91％,是一种重要的辅助手段。
Objective: To analyze the ultrasound diagnosis of 22 patients with hydatidiform mole confirmed by clinical diagnosis and pathology in our hospital since 1983, to summarize the specific changes of the sonogram and the reasons for misdiagnosis. The aim is to improve the ultrasound diagnosis of this disease. Methods: This group of patients for our hospital treatment; using Japanese-made RT-2800 ultrasound system, the probe 3.5MHz. Moderate filling of the bladder ultrasound. Those diagnosed with hydatidiform mole were examined by ultrasound and combined with HCG before the second and third uterine evacuation. RESULTS: Twenty patients with a hydatidiform mole were examined. Ultrasonography showed that the uterus was filled with low-to-medium punctate, lumps, and transverse strip echoes. During the process, many scattered liquid dark areas were present, and the dark areas were round. Shaped, elliptical, fissured, and irregularly shaped, and formed a “honeycomb-like” or “snowfall-like” anomalous structure, with clear boundaries of the uterine wall, regular edges, and sometimes with a low-reverberatory halo. In 7 cases, flavin cysts were seen unilaterally or bilaterally in the uterus. According to the number and size of dark areas in the mole of the mole, this article is divided into small bubble type, large bubble type and atypical type. Two cases were misdiagnosed and the pathology was expired miscarriage. Conclusion: The diagnostic accuracy of hydatidiform mole ultrasound is 91%, which is an important auxiliary measure.