超声在睾丸扭转急性期的诊断价值

The clinical value of ultrasonography in the diagnosis of acute testicular torsion

目的探讨彩色多普勒超声及超声造影在睾丸扭转急性期的诊断价值。方法纳入经手术及超声造影证实的4例睾丸扭转急性期病例,并对术前超声诊断准确率、图像特征、漏误诊原因等进行分析。结果术前超声检查3例睾丸扭转病例诊断正确,符合率75.0%,误诊1例(25.0%)。睾丸扭转急性期病变的主要超声特征为患侧睾丸大小正常或轻度增大,回声不均质,睾丸内血流减少或未见明显减少,睾丸位置改变为横位,精索增粗;误诊1例,患侧睾丸血流较健侧稍多,附睾增大。结论彩色多普勒超声对于诊断急性期睾丸扭转有较高的敏感性和特异性,具有重要的临床应用价值。但检查中也需要注意睾丸扭转急性期的特殊表现,以减少漏误诊病例。

Objective To evaluate the clinical value of color Doppler uttrasonography and radiography in the diag- nosis of acute testicular torsion. Methods 4 cases of testicular torsion patients diagnosed by ultrasound imaging were in- cluded in this retrospective analysis. The accuracy and image characteristics of preoperative ultrasound diagnosis were confirmed with surgery results, and the reasons for misdiagnosis were analyzed. Results 3 cases of the preoperative di- agnoses by ultrasonography were correct with a compliance rate of diagnosis of 75.0% ;~ one case was of misdiagnosis （25.0%）. The main ultrasound characteristic of testicular torsion in the acute phase is a normal or slightly increased tes- ticular size, inhomogeneous echo, slightly decreased testicular blood flow, horizontally transferred testicular position and thickening spermatic cord. In this misdiagnosed case, the testicular blood flow of the affected side was slightly more than the eontralateral size, and the epididymis size was increased. Conclusion Color doppler ultrasonography has high sensi- tivity and specificity in the diagnosis of acute testieular torsion. It is a method of high clinical application value. Howev- er, attentions must he pay to the special performance in acute phase of testicular torsion to reduce misdiagnosis.