彩色多普勒超声在儿童急性阴囊肿痛中的诊断价值

Application value of color doppler ultrasound in acute scrotum pain in children

目的总结彩色多普勒超声(简称“超声”)诊断常见儿童急性阴囊肿痛疾病的临床及声像图表现,分析其特征、诊断要点及鉴别诊断。方法以大冶市人民医院70例儿童急性阴囊肿痛病例为观察对象,行彩超检查详细对比观察双侧睾丸及附睾的大小形态、内部回声、血流情况、睾丸鞘膜腔有无积液、阴囊壁有无水肿增厚等情况。结果70例儿童急性阴囊肿痛病例中,22例经外科手术病理确诊,其余48例经临床对症治疗及彩超复查均有最终结果。70例中64例彩超诊断与最终结果相符合,彩超诊断总体符合率为91.43%,其中彩超诊断睾丸扭转共10例,误诊1例;睾丸附件扭转15例,误诊2例;急性附睾炎23例,误诊1例;急性睾丸炎9例,误诊1例;阴囊创伤8例,0例误诊;阴囊皮肤感染5例,误诊1例。结论彩超诊断儿童阴囊肿痛操作简单、方便快捷,可随访观察,诊断准确率高,能快速区分睾丸扭转、睾丸附件扭转与炎症,评估阴囊创伤的情况及预后、炎症疾病治疗效果等,为临床提供重要诊疗信息,可作为儿童急性阴囊肿痛的首选检查方法。

Objective To summarize the clinical and sonographic manifestations of color Doppler ultrasound in the diagnosis of common children with acute scrotal swelling and pain,and to analyze its characteristics,diagnostic points and differential diagnosis.Methods Taking 70 cases of children with acute scrotal pain in our hospital as the observation object,color Doppler ultrasound was used to observe in detail the size and shape of the bilateral testes and epididymis,internal echo,blood flow,testicular hydrocele,and scrotal wall.Results Of the 70 cases of acute scrotal pain in children,22 cases were confirmed by surgery and pathology,the other 48 cases were treated by clinical symptomatic treatment and color doppler ultrasound.Among the 70 cases,64 cases were diagnosed by color doppler ultrasound,the overall coincidence rate was 91.43%,including 10 cases of testicular Torsion,1 case of misdiagnosis,15 cases of testicular appendage torsion,2 cases of misdiagnosis,23 cases of Acute Epididymitis,1 case of misdiagnosis There were 9 cases of acute orchitis,1 case of misdiagnosis,8 cases of scrotal trauma,O cases of misdiagnosis,5 cases of scrotal skin infection,1 case of misdiagnosis.Conclusion Color Doppler ultrasound is a simple,convenient and quick way to diagnose scrotal pain in children,and it can be followed up for observation,it can quickly distinguish testicular torsion,testicular adnex torsion and inflammation,evaluate the situation and prognosis of scrotal trauma,the treatment effect of inflammatory diseases and so on,it can be used as the first choice for examination of acute scrotal pain in children.