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目的 探讨卵巢血肿的阴道超声声像图特征及如何提高经阴道诊断卵巢血肿的敏感度。方法 对经腹部超声检查探及卵巢内肿块疑卵巢血肿、卵巢巧克力囊肿、卵巢畸胎瘤者共 83例 ,行经阴道超声检查 ,并随访观察 1～ 6个月 ,观察卵巢肿块的转归 ,并追踪手术病理结果。结果 经阴道超声初诊卵巢血肿 2 9例 ,经过 6个月后 ,卵巢血肿自行消退 19例 ,形成潴留囊肿5例 ,手术证实卵巢巧克力囊肿 4例 ,卵巢畸胎瘤 1例 ;经阴道超声诊断卵巢巧克力囊肿 2 7例 ,6个月后 ,肿块自行消退 5例 ,手术后病理证实卵巢巧克力囊肿 2 0例 ,卵巢血肿 2例 ;经阴道超声诊断卵巢畸胎瘤 2 7例 ,6个月后 ,肿块自行消退 2例 ,形成潴留囊肿1例 ,手术后病理证实卵巢畸胎瘤 2 4例。经阴道超声检查初次诊断为卵巢血肿的敏感度率为 70 % ( 2 3 /3 4 ) ,随访观察 6个月后 ,诊断敏感度为 94% ( 3 2 /3 4 )。结论 对初次经阴道超声检查拟诊为卵巢血肿、卵巢巧克力囊肿、卵巢畸胎瘤患者的随访观察能提高经阴道超声诊断卵巢血肿的敏感度 ,减少误诊 ,避免不必要的手术。
Objective To investigate the characteristics of vaginal ultrasonography of ovarian hematoma and how to improve the sensitivity of transvaginal diagnosis of ovarian hematoma. Methods Totally 83 cases of suspected ovarian hematoma, ovarian chocolate cyst and ovarian teratoma were examined by trans-abdominal ultrasonography. Transvaginal ultrasonography and follow-up were performed for 1-6 months to observe the outcome of ovarian masses. Tracing pathology results. Results Transvaginal ultrasonography was used to diagnose ovarian hematoma in 29 cases. After 6 months, 19 cases of ovarian hematoma subsided spontaneously, 5 cases of retention cyst formed, 4 cases of ovarian chocolate cyst and 1 case of ovarian teratoma were confirmed by surgery. Chocolate cysts 27 cases, 6 months after the tumor itself subsided in 5 cases, postoperative pathology confirmed 20 cases of ovarian chocolate cysts, 2 cases of ovarian hematoma; transvaginal ultrasound in the diagnosis of ovarian teratoma 27 cases, 6 months later, The lumps subsided on their own in 2 cases, forming a retention cyst in 1 case. Pathological examination confirmed 24 cases of ovarian teratoma. The sensitivity of transvaginal sonography in the diagnosis of primary ovarian hematoma was 70% (2 3/34). After 6 months follow-up, the diagnostic sensitivity was 94% (3 2/34). Conclusions The follow-up observation of ovarian hematoma, ovarian chocolate cyst and ovarian teratoma diagnosed by transvaginal ultrasonography can improve the sensitivity of transvaginal sonography in the diagnosis of ovarian hematoma, reduce the misdiagnosis and avoid unnecessary surgery.