超声检查睾丸微石症临床意义探讨

Clinical significance of ultrasound in testicular microlithiasis

目的回顾性分析睾丸及附睾超声检查资料,探讨睾丸微石症(TM)临床意义。方法根据TM声像图将其分为典型性TM(CTM)和局限性TM(LTM)。超声显像检查显示典型TM的患者为TM组;同期接受超声检查的患者中发现睾丸、附睾、鞘模腔异常声像图的患者列为其他病变组,未发现睾丸、附睾或(和)鞘模腔异常声像图的患者列为对照组。比较TM及睾丸、附睾、鞘膜其他病变的发生率、年龄以及TM与不同睾丸、附睾、鞘膜其他病变合并发生率、年龄的差异。结果 2002年9月至2009年12月接受睾丸及附睾超声检查的5248例患者中显示189例TM,检出率3.60%(189/5248);平均(35.88±18.22)岁。其中CTM153例,LTM36例,二者之间年龄差异无统计学意义(t=0.71)。同期检查的患者中显示睾丸、附睾或(和)鞘模腔异常声像图2357例,其年龄与TM患者比较,差异有统计学意义(t=0.000)。对照组2702例,其年龄与TM患者比较,差异无统计学意义(t=0.072)。78例TM患者显示了97处附睾、睾丸或(和)鞘膜异常声像图,合并率3.06%(78/2546);69例睾丸实性肿瘤中有7例患者合并CTM,CTM发生率10.14%(7/69),没有发现合并LTM。结论 TM的发生可能和曲细精管的发育缺陷或青少年的某种活动方式、会阴部特别是睾丸易受损伤等有一定的关系,无证据提示TM与睾丸恶性肿瘤有特殊的关系或提示TM就是睾丸癌前病变。

Objective The data of testis,epididymis and vaginal cavity were analyzed retrospectively to explore the clinical significance of testicular microlithiasis（TM）.Methods According to the typical sonogram,TM was divided into Classic TM（CTM） and limited TM（LTM）.All of patients with TM were defined as the observation group（OG） and in the same period,the patients with other abnormalities of testis,epididymis and /or vaginal cavity were identified by ultrasound as the other diseases group（ODG） and no disease was found by ultrasound in testis,epididymis and /or vaginal cavity as control group（CG）.The prevalence of TM and other abnormalities of testis,epididymis and vaginal cavity by ultrasound was obtained.The subject ages as well as the statistical difference in three groups were compared,respectively.The same process was performed in the concurrence incidence between TM and the other abnormalities of testis,epididymis and vaginal cavity.Results TM was found in 189（age ranged from 9 to 84,average of 35.88±18.22 years） of 5248 subjects by ultrasound of testis,epididymis and /or vaginal cavity from Sep.2002 to Nov.2009.The prevalence of TM in all was 3.60%（189/5248）.Of all cases with TM,153 were classified as CTM and the rest,36 cases,were as LTM.The age difference between the objects with CTM and LTM had no statistical significance（t=0.71）.In contrast,the significance difference of the subjects age was obtained between OG of 189 and ODG of 2357 cases in the same period（t=0.000） but the same results had not been found between OG and CG of 2702 objects（t=0.072）.Of 2546 subjects,including OG（189 cases） and ODG（2357 cases）,78 cases with TM had 97 abnormal ultrasonograms in epididymises,testes and vaginal cavity and the concurrence rate was found to be 3.06%（78/2546）.Seven of 69 cases with solid tumors of testis had CTM（10.14%,7/69） and no LTM was found in the patients with testiculoma.Conclusion TM may be resulted from degeneration of the seminiferous tubules and habit of some movement in teenagers and post adolescences,who were impaired more frequently and easily to epididymises,testes and perineal position than other population.There was no evidence that TM has certain relationship with testicular malignant tumor or TM was testicular precancerous lesion.