彩色多普勒超声和超声造影检测睾丸扭转的诊断价值

Color Doppler ultrasound and contrast-enhanced ultrasonography in detection of testicular torsion

目的探讨彩色多普勒超声(CDU)和超声造影(CEUS)对睾丸扭转的诊断价值。方法对17例睾丸扭转患者首先用二维超声显示双侧睾丸附睾形态、结构及内部回声,再用彩色多普勒观察血供状况,其中11例再用SonoVue肘静脉团注法进行超声造影。所有病例均经手术病理证实。结果彩色多普勒显示16例患者睾丸内血流信号明显减少或消失,超声诊断睾丸扭转结果正确;1例患者睾丸内血流较丰富,超声误诊为急性睾丸附睾炎。超声诊断符合率为94.1%。11例超声造影均显示睾丸实质内造影剂充填缺损,诊断符合率为100%。结论彩色多普勒超声和超声造影诊断睾丸扭转有较高的敏感性和特异性,应作为诊断睾丸扭转的首选方法。

Objective To investigate the value of color Doppler ultrasound （CDU） and contrast-enhanced ultrasonography （CEUS） in the diagnosis of testicular torsion. Methods Seventeen patients with suspected testicular torsion were examined by 2D ultrasound for first displaying the morphological changes and internal echoes of testis and epididymus, then the blood perfusion was observed by CDU. CEUS was performed on 11 patients with intravenous bolus injection of SonoVue. All of patients underwent surgery with final diagnosis by pathology. Results Sixteen patients with disappeared or reduced blood flow in the testis diagnosed as torsion of testis were in accordance with operative and pathologic results. One patient without blood flow reduction in testis was misdiagnosed as epididymitis. The accuracy rate of CDU was 94.1%. CEUS in 11 patients of them revealed non-filling of contrast in the torsed testis. The accuracy rate of CEUS was 100%. Conclusion CDU and CEUS have high sensitivity and specificity in diagnosing testicular torsion. They are the methods of first choice to diagnose testicular torsion.