分析和总结妊娠期卵巢子宫内膜异位囊肿蜕膜化的临床特征及超声影像学表现，为临床诊疗提供参考依据。

回顾性分析2021年7月至 2024年11月期间11例在解放军总医院第一医学中心临床诊断为妊娠期卵巢子宫内膜异位囊肿蜕膜化患者的病历资料，包括患者的临床资料、超声图像特征、随访记录及手术病理结果。总结妊娠期卵巢子宫内膜异位囊肿蜕膜化的超声特征和临床鉴别诊断要点。

所有患者超声检查均提示妊娠期伴卵巢囊肿。囊肿最大直径为3.1~7.3 cm，90.9%（10/11）的患者囊内液透声差，乳头个数为1~6个不等；彩色多普勒血流成像示10例乳头状突起内可见血流信号，1例乳头状突起内未见血流信号，72.7%（8/11）血流评分以2~3分为主；8例（72.7%，8/11）子宫滑动征阴性。3例行手术切除治疗，术后病理诊断为卵巢子宫内膜异位囊肿，间质蜕膜样变；8例于超声随诊过程中乳头消失，其中1例产后1年因囊肿破裂经手术后病理证实为卵巢子宫内膜异位囊肿，另2例流产后及5例妊娠后超声复诊发现囊肿形态学改变，结合临床资料，诊断为卵巢子宫内膜异位囊肿蜕膜化。

妊娠期卵巢子宫内膜异位囊肿蜕膜化具有特征性超声表现，结合临床特征及随访变化可提高诊断准确性，避免不必要的手术干预。建议对可疑病例采取动态随访观察的管理策略。

To analyze and summarize the clinical characteristics and ultrasonographic features of decidualized ovarian endometrioma (DOE) during pregnancy to provide a reference for its clinical diagnosis and treatment.

A retrospective analysis was conducted on the medical records of 11 patients clinically diagnosed with DOE during pregnancy at the General Hospital of the PLA from July 2021 to November 2024. The data included clinical information, ultrasound images, follow-up records, and surgical pathological results. The ultrasonographic characteristics and key points for clinical diagnosis and differentiation of DOE during pregnancy were summarized.

All patients exhibited ovarian cysts during pregnancy on ultrasound. The largest diameter of the endometriomas ranged from 3.1 to 7.3 cm, 90.9% (10/11) showed poor echogenicity of intracystic fluid, and the number of papillary projections ranged from 1-6 per cyst. Color Doppler flow imaging detected blood flow signals in 10 cases (flow scores: 2-3 in 72.7% [8/11]), and 72.7% (8/11) had a negative "sliding uterus sign". Three patients underwent surgical resection and had histologically confirmed benign DOE. Sign of decidualization disappeared in 8 cases during the follow-up period. Among these, one case had histologically confirmed benign DOE after surgery due to cyst rupture one year after pregnancy, The remaining 2 cases after abortion and 5 cases during pregnancy showed morphological changes in the cysts in the follow-up period, leading to a diagnosis of DOE based on clinical data.

DOE during pregnancy exhibits characteristic ultrasonographic features. Combining clinical characteristics and follow-up changes can improve diagnostic accuracy and avoid unnecessary surgical intervention. A dynamic follow-up observation strategy is recommended for suspected cases.