超声检查对睾丸肿瘤的诊断价值(附61例分析)

Clinical Value of Scrotal Ultras ound in the Investigation of Testicular Tumor.

目的 评价 B超检查在睾丸肿瘤诊断中的临床应用价值。方法 对于 6 1例临床或超声检查拟诊为睾丸肿瘤患者的体检发现、超声诊断及病理结果进行比较分析。结果 6 1例中 5 7例 B超检查发现睾丸内肿块 ,其中 14例肿块体检不能扪及 ,4例临床诊断为睾丸肿瘤者 B超检查排除了睾丸内肿块 ,4 3例患者的临床与超声诊断相符。B超诊断睾丸癌的敏感性达 10 0 % ,但特异性仅 2 3.5 %。所有患者均行手术 ,4 4例睾丸恶性肿瘤行根治性睾丸切除 ,17例睾丸良性病变除 2例行术中冰冻切片检查排除恶性而保留睾丸外 ,其余都切除睾丸。结论 B超能够显著提高临床诊断睾丸肿瘤的敏感性并减少假阳性数 ,B超证实或发现的睾丸实质性肿块均应手术 。

Objective To assess the role of ultrasound(US) in the investigation of testis tumor.Method The diagnost ic results of clinical examination,gray scale ultrasonography and pathology for suspected testis tumor were compared in 61 patients.Results Intratesticu lar lesions were detected by US in 57 pa tients,of which 14 were nonpalpable by c linical examination.The diagnosis of tes tis tumor in 4 patients based on phisica l examination was excluded by US.In 43 p atients the findings on US correlated we ll with the clinical diagnosis.The sensi tivity and specificity for US were 100% and 23 5% respectively.All 61 underwent surgery,pathological examination reveale d malignant tumor in 44.Conclusions US is very sensitive in detecting te stis tumor and may reduce the number of false positive clinical diagnosis.If an intratesticular lesion is detected on US ,exploration is indicated.The use of fro zen section biopsy may allow avoiding un necessary orchidectomy without missing t estiscular malignancy.