超声多普勒检查在阴囊急症中的应用

Clinical application of Doppler ultrasonography for the diagnosis of acute scrotal disease

目的探讨阴囊急症的彩色多普勒血流显像(CDFI)和彩色多普勒能量图(CDE)特征及其鉴别诊断。方法用CDFI和CDE观察64例阴囊急症病灶区血供状况,并与健侧比较。对37例急性附睾炎及睾丸炎的附睾动脉和3例早期睾丸扭转的睾丸内动脉的血流参数进行检测,并与30例正常人对照。结果45例急性附睾炎及睾丸炎中37例表现为高血供,附睾内血流速度明显高于正常对照组,阻力指数低于正常对照组(P<0.01);5例病变侧睾丸无血供或低血供,睾丸内血流阻力指数增高,超声诊断睾丸扭转,与手术病理诊断相符;3例睾丸附件扭转,附件内无血流信号显示,而附着处组织血供增多;11例阴囊外伤中,睾丸完全破裂1例,部分破裂2例,挫伤5例,单纯血肿3例。结论CDFI和CDE可准确地鉴别睾丸扭转、睾丸附件扭转和炎症,有助于睾丸损伤的临床治疗方案的选择,可作为阴囊急症诊断的首选检查方法。

Objective To investigate the diagnostic value of color Doppler flow imaging （CDFI） and color Doppler energy imaging （CDE） in acute scrotal disease. Methods Blood supply of 64 patients were observed by CDFI and CDE using direct detection method. Compared with the uninjured side of the scrotum, the blood supply of the suffered scrotum was divided into four groups, according to high blood flow, normal blood flow, low blood flow and no blood flow. The epididymis arteries of 37 patients with acute epididymitis and orchifis and the orchidie internal arteries of 3 patients with early testis torsion were detected, And the results were eompared with 30 healthy volunteers. Results The blood flow velocity of 37 among 45 acute epididymifis or orchifis patients was higher than that in normal group, while the resistance index was lower than that in the normal group（ P 〈0.01 ）. The patients with testicular torsion have low or no blood supply, while the resistance index was high, which were in accordance with the operative and pathologic results. Color Doppler showed no blood flow in the nodules but increased blood flow in the sunroundings in the ther 3 patients with testieular torsion. Among 11 eases of scrotum trauma, one was entirely, 2 were partly ruptured, 5 were contused and 3 were only haematomas. Conclusion and CDE can exactly distinguish testicular torsion, testienlar appendage torsion, orchiepididymitis and orchids. It should be regarded as the first choice for diagnosing of acute scrotum trauma.