附睾结核高频彩色多普勒超声与超声造影表现

High-frequency Colour Doppler Ultrasound and Contrast-enhanced Ultrasound Performance of Epididymis Tuberculosis

目的分析附睾结核高频彩色多普勒超声与超声造影的声像图特征,以评价和提高超声检查对附睾结核的诊断价值。方法回顾性分析该院26例经临床病理确诊的附睾结核患者的高频彩色多普勒超声与超声造影表现。结果26例附睾结核多数表现为附睾肿大,结构紊乱,回声低弱,血流稀疏,少数情况下表现为充血性改变,部分伴结节样低回声,液化者表现为透声差的不规则暗区,以尾部最多见。部分病变区域可见斑点状钙化,11例睾丸受累者,睾丸内可见多数弥漫分布斑点灶性低回声,2例累及阴囊壁,并穿破皮肤形成窦道。该组超声造影附睾结核病灶表现为同步或略早于正常睾丸组织增强,达峰时呈不均匀性高增强,可见多处不规则的无增强区,病灶呈"烂絮状"。11例侵犯睾丸者,睾丸病灶也表现为同步或略早于正常睾丸组织不均匀性高增强伴多处不规则的无增强区。结论附睾结核是临床上最常见的男性生殖系统结核,彩色多普勒超声结合超声造影可以有效提高其诊断与鉴别诊断价值。

Objective To analyse the feature of high-frequency colour doppler ultrasound and contrast-enhanced ultrasound（CEUS）, and evaluate its diagnosis value in the diagnosis of epididymis tuberculosis. Methods The high-frequency colour doppler ultrasound and contrast-enhanced ultrasound performance of 26 cases of epididymis tuberculosis patients confirmed by pathological examination were retrospectively analyzed. Results The common ultrasound performance was epididymal enlargement, structural disorder, low and weak echo, blood thinning, few cases showed congestive changes, some with nodular hypoechoic, or with liquefaction which performed as irregular dark area to the tail with poor sound penetration.Among 11 cases with testicular involvement, visible diffuse hypoechoic focal spot exsited in the testiculars, 2 cases were involved with the scrotal wall, and punctured the skin to formate sinus. CEUS showed synchronous or a little earlier ultrasound performance than normal testis tissue, when reached peak, uneven high enhancement or multiple irregular no enhancement area were showed, the lesions were ＂rotten flocculent＂. 11 case with testicular involvement, testicular lesions also showed synchronous or slightly earlier than normal testis tissue, which performed as inhomogeneity highly reinforcement with multiple irregular no enhancement zone. Conclusion Epididymis tuberculosis is the most common male genital tuberculosis, high-frequency colour doppler ultrasound combined with CEUS has greater value in the diagnosis and differential diagnosis of epididymis tuberculosis.