彩色多普勒超声对睾丸扭转后睾丸存活力的评价

Evaluation of the viability of the testis after testicular torsion by color Doppler ultrasonography

目的了解彩色多普勒在睾丸扭转复位后存活力预测中的临床应用价值。方法随机选取39例睾丸扭转患者作本次临床研究调查对象,并对其手术前后阴囊彩色多普勒影像表现进行分析,将整个手术中的睾丸活力分作Ⅰ~Ⅲ级,保留Ⅰ、Ⅱ级活力睾丸。结果 39例睾丸扭转患者中11例行睾丸复位固定术治疗,A级4例,术中睾丸活力Ⅰ级3例、Ⅱ级1例、Ⅲ级0例;B级3例、术中睾丸活力Ⅰ级2例、Ⅱ级1例、Ⅲ级0例;C级4例、术中睾丸活力Ⅰ级1例、Ⅱ级3例、Ⅲ级0例。另28例患者行睾丸切除术,无一例手术与麻醉并发症患者,后均经病理证实。声像图中患侧睾丸变大,实质回声不均匀、呈大片放射状低回声,睾丸实质无血流信号提示失睾可能性大;而睾丸回声均匀或局部为放射状、片状低回声,彩色多普勒超声探及少量彩色血流则提示存活的可能性大。结论声像图中患侧睾丸内部回声及血流改变可作为术前预判睾丸扭转患儿转归的指标。临床可通过多普勒超声影像来评价复位后睾丸存活性,为扭转后复位睾丸活力的评测提供重要的信息。

Objective To understand the value of the clinical application of color Doppler in the prediction of the survival of testicular torsion. Methods Randomly selected 39 cases of testicular torsion in patients with the clinical research object in English abstract, and scrotal color Doppler imaging before and after surgery analysis of the operation of testicular viability into I -III grade, reserve grade I and II activity of testis. Results 11 cases of testicular reduction and fixation for the treatment of 39 cases of testicular torsion, 4 cases of Grade A, grade of testicular viability in 3 cases of grade I, 1 cases of grade＇ II, 0 cases of grade III; testicular viability grade B grade 3 cases, surgery in 2 cases of grade I, 1 cases of grade II, 0 cases of grade III in testicular viability; C grade 4 cases, surgery in 1 cases of grade I, 3 cases of grade II, and 0 cases of grade IlL The other 28 pa- tients underwent testicular resection, none of the patients with complications of anesthesia and anesthesia were confirmed by pathology. Ultrasonogra- phy in testicular parenchyma becomes large, uneven, a large radial hypoechoic parenchyma of testis, no blood flow signal loss and the possibility of testis; testicular echo uniform partial or radial, hypoechoic, color Doppler ultrasound probe and a small amount of color flow is suggested the possi- bility of survival. Conclusion The internal echo and blood flow changes in the ipsilateral testis were used as an indicator of the prognosis of the pa- tients with testicular torsion before surgery. Clinical data can be used to evaluate the testicular viability after reduction by Doppler ultrasound imag- ing, which provides important information for the evaluation of testicular viability after torsion.