小儿急性睾丸附件扭转的彩色多普勒超声诊断

Differential diagnosis of color Doppler ultrasound in acute torsion of testicular appendage in children

目的 探讨小儿急性睾丸附件扭转（TTA）的彩色多普勒超声诊断及鉴别诊断。方法 回顾性分析26例急性TTA患儿的临床资料及彩色多普勒超声声像图表现。结果 26例急性TTA患儿,彩色多普勒超声检查确诊24例,误诊2例,超声诊断符合率为92.3%（24/26）。TTA的主要超声声像图表现为睾丸上方周围可见略高回声结节,直径4～12mm,结节内部回声尚均匀,部分内部回声不均匀者,对附睾头部挤压明显。彩色多普勒血流显像显示结节内部未见血流信号,结节周边早期可见较多血流信号,晚期周边血流信号逐渐减少。结论 彩色多普勒超声检查对小儿急性TTA具有较高的诊断准确率,但在检查中要注意多切面、多角度检查,避免误诊。

Objective To explore the differential diagnosis of children with acute torsion of testicular appendage（ TTA）by color Doppler ultrasound. Methods The clinical data and color Doppler sonographic appearance of 26 children with acute TTA were analyzed retrospectively. Results Among the 26 cases,24 cases were confirmed by color Doppler ultrasonography,2 cases were misdiagnosed,the ultrasonic diagnose accordance rate was 92. 3%（ 24 /26）. The main sonographic appearance of TTA include that slightly hyperechoic nodules around the top of the testicle could be seen,the diameter was 4- 12 mm,internal echo of the nodules were uniform; the globus majors were extruded significantly in the cases which had nonuniform internal echo of the nodules. color doppler flow imaging showed that no blood flow signal appeared within the nodules,more blood flow signals could be found around the nodules in the early stage,the surrounding blood flow signals decreased gradually. Conclusions Color Doppler ultrasonography has a high accuracy in the diagnosis of children with acute TTA. In order to avoid misdiagnosis,the doctors should pay attention to multi-slice,multi-angle inspection during the inspection.