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目的探讨超声对于卵巢肿瘤蒂扭转的诊断价值。方法采用腹部探头和阴道探头同时对75例卵巢肿瘤蒂扭转患者进行了检查,并与手术和病理结果进行比较分析。结果超声诊断正确65例,正确率86.7%。有10例漏诊或误诊,其中5例仅诊断为卵巢肿瘤,未诊断出合并蒂扭转;2例误诊为黄体破裂,2例误诊为盆腔脓肿,1例误诊为阑尾脓肿。超声声像显示肿块多呈类圆形,多数边界不清,囊性者囊壁增厚水肿,内透声欠佳。内部回声除依据各自病理类型不同而有相应超声声像改变外,内部回声不均匀,可见点状弱回声。部分肿块与子宫间可见瘤蒂扭转呈局部低回声团块或麻花状改变,局部探头加压时压痛明显。结论超声检查无创、操作简便、准确性高,对于卵巢肿瘤蒂扭转具有较高诊断价值。为了减少误诊,检查时应注意与其他急腹症相鉴别。
Objective To investigate the diagnostic value of ultrasound in the diagnosis of pedicle torsion in ovarian tumors. Methods Totally 75 patients with torsion of ovarian tumor were examined by abdominal probe and vaginal probe. The results were compared with the surgical and pathological findings. Results The correct ultrasound diagnosis of 65 cases, the correct rate of 86.7%. There were 10 missed or misdiagnosed cases, of which 5 cases were diagnosed as ovarian tumors only, and the combined pedicle torsion was not diagnosed. 2 cases were misdiagnosed as corpus luteum rupture, 2 cases misdiagnosed as pelvic abscess and 1 case misdiagnosed as appendix abscess. Ultrasonography showed almost round the mass, most of the border is unclear, cystic wall thickened edema, poor sound penetration. In addition to the internal echo depending on the type of pathological changes in the corresponding ultrasound ultrasound, the internal echo is not uniform, we can see the point-like weak echo. Partial tumor and uterus showed tumoral torsion showed local hypoechoic mass or twist-like changes, local pressure probe tenderness significantly. Conclusion Ultrasonography is noninvasive, easy to operate and has high accuracy. It has high diagnostic value for torsion of ovarian tumors. In order to reduce misdiagnosis, examination should be noted and other acute abdomen phase identification.