Analysis of Misdiagnosis and Missed Diagnosis of Nine Cases of Retroperitoneal Fibrosis with Ultrasound

WANG Da-wei; HE Yi

doi:10.3969/j.issn.1002-3429.2018.01.035

Abstract：Objective The causes of misdiagnosis and missed diagnosis of retroperitoneal fibrosis ( RPF) with ultra-sound were analyzed, objective to improve the awareness of ultrasound doctors in this disease. Methods 9 cases of RPF in our hospital misdiagnosis and missed diagnosis by ultrasound initial diagnosis were reviewed and analyzed retrospectively from May 2010 to June 2017. Results All the 9 patients had symptoms of lumbar and abdominal discomfort, pain and hematuria. 7 patients suffered from knocking pain, 6 with oliguria, 4 with edema of lower extremities, and 1 with abdominal mass;Ultra-sonographic features:9 patients showed abdominal aorta lateral wall surrounds the hypoechoic lesion, the boundary is not clear, there are 3 cases of downward continuation to the iliac vessels, 6 cases of inferior vena cava is wrapped around, CDFI showed no obvious blood flow signal. All of 9 cases were associated with urinary tract positive signs, 5 cases were bilateral, 4 were unilateral, the invasion of the ureter below the lesion is unclear, 1 cases of renal hilum showed a hypoechoic mass around, CDFI showed renal vascular also buried;all the 9 cases were misdiagnosed at ultrasound first visit, consider the kid-ney or ureter tumor and abdominal tumor in 3 cases, hydronephrosis or upper ureteral dilatation in 2 cases, 1 case of arteritis in abdominal aorta, all the cases were confirmed by surgery, pathology or biopsy was RPF. Conclusion The possibility of RPF may be considered when ultrasound reveals abnormal echogenic masses surrounding the retroperitoneal vessels with hydro-nephrosis and ureteral dilatation, the diagnosis should be confirmed by pathological examination.