超声检查在儿童急性特发性阴囊水肿和急性睾丸附件扭转鉴别诊断中的应用

The Application of Ultrasonography in the Differential Diagnosis of Acute Idiopathic Scrotal Edema and Acute Testicular Appendage Torsion in Children

目的:探讨超声在儿童急性特发性阴囊水肿(Acute Idiopathic Scrotal Edema,AISE)与急性睾丸附件扭转的鉴别诊断。方法:回顾性分析12例AISE患儿和43例睾丸附件扭转患儿的超声声像图特点,分析其异同,总结两者鉴别要点。结果:所有AISE的患儿阴囊壁均有水肿增厚,阴囊壁容易被探头压缩,超声表现为阴囊壁内丰富血流信号,均观察到患侧腹股沟淋巴结肿大与丰富血管,而睾丸附睾形态、血流信号正常。睾丸附件扭转患儿的超声表现为患侧附睾区回声杂乱,也可探及附睾头或睾丸旁高回声或中等回声结节,睾丸及附睾常轻度增大,部分睾丸实质回声不均匀,睾丸内血流轻度增多,可伴有鞘膜积液,少部分阴囊壁可增厚。结论:超声检查在儿童AISE与睾丸附件扭转诊断及鉴别诊断中有一定价值,其中阴囊壁水肿、探头按压可压缩性、腹股沟淋巴结肿大伴血供增加以及附睾回声杂乱、睾丸旁出现高回声或中等回声结节是两种疾病的鉴别要点。

Objective： To explore the differential diagnosis of ultrasound in acute idiopathic scrotal edema（AISE） and acute testicular appendage torsion. Methods： Retrospective analysis of 12 cases of the children of AISE and 43 cases of testicular appendage torsion of the children with ultrasonographic features of ultrasound, analysis of their similarities and differences, and summarize the key points of identification. Results： All children with scrotal wall AISE edema thickening, scrotal wall easy to probe compression, ultrasound experience abundant blood flow signals inside the scrotal wall, were observed with bilateral inguinal lymph node enlargement and rich blood vessels, and epididymis testicular morphology, normal blood flow signals. Testicular appendage torsion with green sonographic findings for lateral epididymis echo, also can explore and epididymis head or high or medium echo tubercle of the echo testicles, testis and epididymis is often mild increase, part of testicular essence uneven echo, testicular blood flow within the mild increase, maybe accompanied by hydrocele, a small number of scrotal wall thickening. Conclusion： Ultrasound AISE and testicular appendage torsion in children have certain value in diagnosis and differential diagnosis, the scrotal wall edema, the probe on the compressibility, inguinal lymph node enlargement with blood and epididymis echo clutter, testis appeared beside high or medium echo tubercle of the echo is to identify points of the two diseases.