超声检查对无痛性附睾结节的鉴别诊断价值

Ultrasound differential diagnosis of painless epididymal nodules

目的探讨各种无痛性附睾结节的超声表现及超声检查对其鉴别诊断价值。方法应用二维及彩色多普勒超声对24例无痛性附睾结节患者进行术前检查,检查结果与手术病理相对照。结果24例无痛性附睾结节患者中附睾精子肉芽肿10例,超声显示结节形态呈类圆形,内部呈低回声或回声增强,分布不均,彩色多普勒血流成像(CDFI)示内部血流信号稀少或无血流信号;附睾腺瘤样瘤7例,超声表现为边界规整,回声中等均匀,形态呈圆形;附睾静脉曲张4例,声像图呈“蜂窝样”无回声结构,CDFI示无回声区内为低速静脉血流信号;附睾平滑肌瘤3例,超声显示包膜完整,结节呈圆形,边界规整,动态观察球体感明显,内部回声均匀,CDFI显示血流信号较丰富。结论超声检查能提示无痛性附睾结节的部位、内部结构及血供情况,是附睾无痛性结节鉴别诊断的首选方法。

Objective To study the ultrasound characteristics and differential diagnostic value in painless epididymal nodules. Methods Totally 24 cases with painless epididymal nodules underwent gray-scale and color Doppler flow imaging (CDFI) before operation. Results All results were compared with operative pathology. In all of these patients , 10 cases were on account of sperm granuloma which showed elliptical contour with inner strong uneven echoes and with rare or without blood flow on CDFI; 7 with adenomatoid tumors which were round in shape with sharp borders and inner homogeneous moderate echoes; 4 with epididymal varices showing huneycomb-like without echoes where CDFI showed low velocity venous flow in the anechoic area; 3 with epididymal leiomyomas the nodules of which were round in shape with complete capsule and global-like on dynamic observation. The inner construction was even with abundant blood flow signals on CDFI. Conclusions Ultrasound can provide the messages of the position, internal structures and blood flow signals of the nodules. It is the first choice for differential diagnosis of the epididymal painless nodules.