彩超诊断附睾腺瘤样瘤2例报告并文献复习

Color Doppler ultrasound diagnosis of epididymal adenomatous tumor (report of 2 cases and review of the literature)

目的提高临床医生对超声诊断附睾腺瘤样瘤的认识。方法报告2例彩超诊断附睾腺瘤样瘤的患者,并结合文献复习其解剖、临床、病理和超声特征。首先2例患者术前使用二维超声观察记录肿块大小、形态、部位、边界、内部回声,并用彩色多普勒(CDFI)检查,记录其彩色血流信号分布,将取样容积置于血流信号最丰富处,获取频谱,使声束和血流的夹角<60°,测定收缩期血流速度、阻力指数等参数。后经手术顺利切除附睾肿瘤。结果2例附睾肿块均呈等回声、边界规则的肿块,内部回声均匀。1例位于右附睾头的肿块,内部未探及明显彩色血流信号;1例位于左附睾头的肿块,内部探及少量彩色血流信号,最大流速16cm/s,RI:0.62。术后病理诊断为附睾腺瘤样瘤。结论附睾腺瘤样瘤临床少见,超声检查可在附睾头或尾部见到等回声,形态规则,边界清晰完整,内部回声均匀,CDFI示无或有少量彩色血流信号的肿块,腺瘤样瘤可能性大。

Objective To better understand clinical and ultrasound characteristics of epididymis adenomatoid tumor. Methods Report of two cases of epididymis adenomatoid tumor diagnosed by color doppler ultrsound and summerize its anatomy, clinical pathology and ultrasound characteristics combined literature review. The two patients were first recorded with two-dimensional ultrasound before operation such as mass size, shape, location, borders, internal echo, and then its color flow signal distribution was recorded by color doppler （CDFI）. Sampling volume was put into the most abundant blood flow. The spectrum was obtained., The angle between sound beam and flow was below 60 degree. Systolic flow velocity, resistance index and other parameters were measured. The epididymis adenomatoid tumor was surgically resected. Results Both epididymal masses mass echo rules and internal echo were all uniform in two cases. One cases with the head of right epididymis mass did not show obvious color flow signal; One cases with the head of left epididymis mass showed few color flow signals, the largest speed of flow was 16 cm/s, RI： 0.62. Epididymal adenomatoid tumor was confirmed bypathological analysis after operation. Conclusion Epididymis adenomatoid tumor was a rare disease and its ultrasonography analsis showed echo at epididymal head or tail, clear boundary integrity, uniform internal echo. No or small amount of color flow signals mass might be CDFI character of adenomatoid tumor