CT Imaging Findings and Misdiagnosis of Patients with Pelvic Endometrio-sis

SONG Baoyu; XU Bin

doi:10.3969/j.issn.1002-3429.2023.07.003

Abstract：Objective To analyze the clinical and CT imaging manifestations,causes of misdiagnosis and preventive measures of pelvic endometriosis(PE).Methods The clinical data of 14 patients with PE who were initially misdiagnosed as functional ovarian cyst and cystadenoma from January 2020 to February 2022 were retrospectively analyzed.Results All the 14 cases had large mass in the left lower abdomen,including menstrual disorder in 10 cases,dyspareunia in 7 cases,dysmen-orrhea in 6 cases,and low fever in 2 cases.In 14 cases,white blood cell(WBC)count,C reactive protein(CRP)slightly increased in 2 cases respectively,hemoglobin decreased,and cancer antigen 125 slightly increased in 5 cases.After CT exam-ination,the preliminary diagnosis was ovarian functional cyst in 11 cases and cystadenoma in 3 cases.The duration of misdi-agnosis was 2-3 d.All the 14 cases underwent laparoscopic surgery and were diagnosed as pelvic endometriosis by pathological examination.Laparoscopic ectopic lesion resection was performed,and no recurrence was observed at 1-year follow-up.Con-clusion The early symptoms of PE are often atypical,and are more likely to cause misdiagnosis.To strengthen the under-standing of this disease,patients with abdominal pain,menstrual disorder,dyspareunia,and pelvic mass as the main symp-toms should be carefully differentiated and diagnosed,and timely laparoscopic pathological examination,as well as early diag-nosis and treatment should be performed when CT examination fails to make a clear diagnosis.