高频超声诊断小儿腹外型未触及睾丸

High frequency ultrasonography in diagnosing extra-abdominal impalpable testes of children

目的探讨高频超声对小儿腹外型未触及睾丸的诊断价值。方法对48例(53侧)腹外型未触及睾丸患儿,术前应用高频超声检查确定睾丸的部位、大小,并与手术病理学结果对比,分析睾丸残余与睾丸缺如结节大小、健侧睾丸大小的差异。结果高频超声诊断腹外型未触及睾丸的总检出率为83.02%(44/53),腹股沟型近区内环口处检出率为100%(4/4);腹股沟型伴嵌顿疝检出率为100%(2/2);睾丸残余及睾丸缺如检出率为80.85%(38/47)。声像图示小结节与腹股沟区低回声条索样精索结构相连,轮廓欠清,CDFI于内部均未探及明显血流信号。单侧腹外型睾丸残余结节长径[(0.71±0.08)cm]大于睾丸缺如结节[(0.62±0.14)cm],差异有统计学意义(F=4.698,P=0.037),而前后径及健侧睾丸大小差异均无统计学意义(P均<0.05)。结论高频超声对腹外型未触及睾丸有一定的定位诊断价值,对临床手术方式、部位的选择有参考作用。

Objective To explore clinical value of high frequency ultrasonography in diagnosing children extra-abdominal impalpable testes.Methods A total of 48 children with 53extra-abdominal impalpable testes underwent routine ultrasonography examination for identifying the sites and sizes of the testes.The results of ultrasonography were compared with surgery and histopathology.And the size of the nodule of testicular residual was compared with that of testicular absence.The size of the testis on contralateral side was compared between testicular residual and testicular absence.Results The total detection rate of ultrasonography with high frequency of extra-abdominal impalpable testes was 83.02%（44/53）.While the detection rate was 100%（4/4）of inguinal testes close to the inner ring,100%（2/2）of inguinal testes with incarcerated hernia,80.85%（38/47）of testicular absence and testicular residual,respectively.High frequency ultrasonography features of testicular residual and testicular absence included nodules connecting with vague boundaries spermatic cord in inguinal region and without evidence of blood flow.The long diameter of the nodules in testicular residual（[0.71±0.08]）cm was longer than that in testicular absence（[0.62±0.14]）cm（F=4.698,P=0.037）.There was no significant difference in the anteroposterior diameter of the nodule and the size of contralateral testis between testicular residual and testicular absence（both P〉0.05）.Conclusion High frequency ultrasonography has certain clinical value on location of diagnosing extra-abdominal impalpable testes and is useful to provide references for the choice of clinical surgery procedures.