摘要 目的 总结分析膀胱子宫内膜异位症的临床表现及超声声像图特征，探讨超声诊断膀胱子宫内膜异位症的价值。 方法 回顾性分析我院1994年1月—2018年1月经手术病理检查确诊的膀胱子宫内膜异位症39例患者的既往史、临床症状及超声图像表现。 结果 39例患者30例有经期膀胱刺激征，36例有剖宫产史或盆腔子宫内膜异位症相关手术史，29例合并其他部位的子宫内膜异位症。38例为单发病灶，1例为2个病灶。其中36个病灶位于膀胱后壁或顶部。超声检查子宫内膜异位症病灶显示，11个病灶内部可见筛孔状无回声区，9个病灶周边可见高回声晕环。37个病灶内部呈无或少许血流信号。25例患者探头滑动时子宫与膀胱间相对运动消失。 结论 超声科医师应该熟悉膀胱子宫内膜异位症的超声表现，对于合并其他部位的子宫内膜异位症且同时具有经期尿频、尿痛、血尿等相关泌尿系症状的膀胱结节，应考虑到膀胱子宫内膜异位症的可能性。 Abstract：Objective To summarize and analyze the clinical manifestations and ultrasonic features of bladder endometriosis and to investigate the diagnostic value of ultrasound for bladder endometriosis. Methods A retrospective analysis was performed on the past history, clinical symptoms, and ultrasound findings of 39 patients with bladder endometriosis confirmed by surgical pathology in our hospital from January 1994 to January 2018. Results Among the 39 patients, 30 had menstrual bladder irritation, 36 had a history of cesarean section or pelvic endometriosis surgery, and 29 also had endometriosis at other sites. Thirty-eight cases had single lesions, and one case had two lesions. Thirty-six lesions were located on the posterior wall or top of the bladder. Ultrasound examination of endometriosis showed mesh-like echoless areas in 11 lesions and hyperechoic halos around 9 lesions. There was no or little blood flow signal in 37 cases. The relative movement between the uterus and the bladder disappeared when the probe was sliding in 25 patients. Conclusion The doctors in the department of ultrasound should be familiar with the ultrasound findings of bladder endometriosis. For bladder nodules with endometriosis at other sites as well as urinary system symptoms such as frequent micturition, micturition pain, and hematuria during the menstrual period, the possibility of bladder endometriosis should be considered
