超声造影环状增强模式评估扭转睾丸损伤的实验研究

Evaluating the extent of testicular injury with the ring-enhancement by contrast-enhanced ultrasound in testicular torsion

目的超声造影环状增强现象评估扭转睾丸的损伤程度及其意义。方法实验采用20只家兔,手术制成假手术组对照组(5只),扭转组(5只)及复位组(10只),并按复位后睾丸内有无灌注分为复位成功组及复位失败组,于手术前后各时段行超声造影检查,绘制时间-强度曲线(TICs)分析达峰时间(time to peak intensity,TP)、强度峰值(peak intensity,PI)、伽马曲线尖度(Shapness,β)及曲线下面积(AUC)等参数变化。结果 1)扭转组及复位组均显示环状灌注增强,而对照组无环状增强;2)扭转组随时段延长环状灌注逐渐增强,主要表现为PI升高(P<0.05);3)睾丸复位后仍有环状增强但复位成功组晕环PI值低于扭转组(P<0.01)及复位失败组(P<0.05);4)复位前复位失败组晕环PI较复位成功组高(P<0.05)。结论超声造影时间-强度曲线分析对评估扭转睾丸的损伤程度有重要价值。

Objective To evaluate the extent of testicular injury with the ring-enhancement by contrast-enhanced ultrasound in testicular torsion. Methods 20 Rabits were randomly allocated into three groups： conto] group, torsion group and detorsion group. The detorsion group was also divided into two groups by the result of testicular salvage. Contrast-enhanced ultrasound was performed and it was analyzed by time-intensity curve （TIC）. Results Ring-enhancement was found in all the 15 cases of tes- ticular torsion after the injection of contrast agent （Sonovue） ; In the torsion group, PI of the ring-enhancement increased with the duration of torsion. In the detorsion group, at the stage either before or aftert detorsion, PI of the ring-enhancement was higher in which group the testis finally didn＇ t recover. （ P 〈 0.05 ）. Conclusion The ring-enhancement is related with the extent of tes- ticular injury and its prognosis, which will help in the diagnosis of testieular torsion and follow-up .