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中华医学超声杂志(电子版) ›› 2023, Vol. 20 ›› Issue (07) : 701 -704. doi: 10.3877/cma.j.issn.1672-6448.2023.07.006

超声医学质量控制

腹膜后神经鞘瘤的超声诊断质量及其影响因素分析
武玺宁, 张培培, 齐振红, 张璟, 赵瑞娜, 孟华(), 李建初   
  1. 100730 中国医学科学院 北京协和医学院 北京协和医院超声医学科
  • 收稿日期:2022-05-29 出版日期:2023-07-01
  • 通信作者: 孟华
  • 基金资助:
    2019年度北京协和医院青年基金(pumch201911591)

Quality of ultrasonic diagnosis of retroperitoneal schwannomas and its influencing factors

Xining Wu, Peipei Zhang, Zhenhong Qi, Jing Zhang, Ruina Zhao, Hua Meng(), Jianchu Li   

  1. Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
  • Received:2022-05-29 Published:2023-07-01
  • Corresponding author: Hua Meng
引用本文:

武玺宁, 张培培, 齐振红, 张璟, 赵瑞娜, 孟华, 李建初. 腹膜后神经鞘瘤的超声诊断质量及其影响因素分析[J]. 中华医学超声杂志(电子版), 2023, 20(07): 701-704.

Xining Wu, Peipei Zhang, Zhenhong Qi, Jing Zhang, Ruina Zhao, Hua Meng, Jianchu Li. Quality of ultrasonic diagnosis of retroperitoneal schwannomas and its influencing factors[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 701-704.

目的

评价腹膜后神经鞘瘤的超声诊断质量,分析其影响因素并探讨提高诊断质量的措施。

方法

以2015年1月至2022年4月于北京协和医院经手术治疗并病理诊断为腹膜后神经鞘瘤的患者为研究对象,总结术前超声检查结果,以定位诊断和定性诊断为指标评价超声诊断质量。

结果

有完整术前超声报告的腹膜后神经鞘瘤共21例,均为单发,1例(4.8%)超声检查漏诊。超声诊断的20例中,最大直径为(6.7±3.6)cm,16例(80.0%)位于腹部腹膜后,4例(20.0%)位于盆腔腹膜后;14例(70.0%)表现为混合回声的囊实性肿物,6例(30.0%)表现为低回声的实性肿物。20例超声报告中,17例(85.0%)定位诊断符合,3例(15.0%)定位诊断不符合。2例(10.0%)定性诊断符合,18例(90.0%)定性诊断不符合。

结论

腹膜后神经鞘瘤的超声定位诊断准确率高。腹膜后神经鞘瘤缺乏典型超声声像图特征,超声医师应熟悉解剖并重视病史采集,进一步提高其定性诊断的准确性。

Objective

To evaluate the quality of ultrasonic diagnosis of retroperitoneal schwannomas and its influencing factors to find the measures to improve the diagnosis quality.

Methods

From January 2015 to April 2022, patients with retroperitoneal schwannomas who underwent surgery at Peking Union Medical College Hospital were studied. All of the cases were confirmed by pathology. The results of preoperative ultrasound reports were summarized, and the quality of ultrasound diagnosis was evaluated by localization diagnosis and qualitative diagnosis.

Results

There were 21 cases of retroperitoneal schwannomas with preoperative ultrasound report, all of them were single, and one case (4.8%) was missed by preoperative ultrasound. The maximal diameter of the 20 schwannomas diagnosed by preoperative ultrasound was (6.7±3.6) cm, of which 16 (80.0%) were located in the abdominal retroperitoneum and 4 (20.0%) were located in the pelvic retroperitoneum; 14 (70.0%) manifested as a heterogeneous solid and cystic mass, and 6 (30.0%) presented as a hypoechoic solid mass. Among the 20 cases, 17 (85.0%) were in accordance with the localization diagnosis and 3 (15.0%) were not; 2 (10.0%) were qualified for qualitative diagnosis and 18 (90.0%) were not.

Conclusion

Ultrasound has a high accuracy for the localization diagnosis of retroperitoneal schwannomas. Retroperitoneal schwannomas lack typical sonogram characteristics, and sonographers should be familiar with the anatomy and pay attention to the medical history collection to further improve the accuracy of its qualitative diagnosis.

图1 腹部腹膜后神经鞘瘤位于左侧输尿管中段走行区。图a游标示病灶范围,后方为左侧髂动脉(箭头);图b游标示左侧输尿管近心段受压增宽(箭头示左肾,星号为神经鞘瘤)
图2 盆腔腹膜后神经鞘瘤,子宫及双附件切除术后超声声像图。图a游标示右附件区囊实性肿物;图b彩色多普勒血流显像可见肿物内部散在条状血流信号 注:BL为膀胱
图3 超声报告提示腹膜后肿物位于左肾下极、腰大肌前方,考虑为神经来源。图a游标示病灶范围,箭头示左肾下极;图b示肿物位于左侧腰大肌(星号)前方
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