睾丸附件扭转的彩色多普勒超声诊断价值

The value of sonographic diagnosis of twisted testicular appendages

目的 探讨彩色多普勒超声对睾丸附件扭转的诊断价值。方法 对 5 8例急性阴囊肿痛的患儿进行灰阶及彩色多普勒超声检查 ,诊断睾丸附件扭转 48例 ( 49侧 ) ;并对手术和保守治疗证实的 48例患者的声像图进行回顾分析。结果 49侧睾丸附件扭转中 ,超声显示睾丸附睾头间、睾丸上极和附睾头旁结节 (扭转的睾丸附件 ) 45例 ,结节多呈不均质高回声 ;42例结节内未显示血流信号 ;睾丸、附睾肿大及其血流信号增多 41例 ;阴囊壁增厚 39例 ;睾丸鞘膜积液 31例。 48例中 ,超声诊断正确 45例 ,误诊 3例 ,诊断符合率为 93.5 %。结论 睾丸附睾头间及睾丸附睾旁高回声结节是睾丸附件扭转的特征性声像表现。彩色多普勒超声对本病诊断准确性高 。

Objective To explore the value of sonographic diagnosis in paitents with torsion of testicular appendage.Methods In 58 children with acute scrotal pain and swelling,gray-scale and color Doppler ultra sonography were performed and the diagnosis of torsion of testicular appendage was made in 48 cases (49 sides).The sonography of 48 cases confirmed by subsequent operation and conservative treatment were analysed retrospectively.Results In all patients,48 cases of torsion of tesicular appendage were confirmed with specific sonographic appearance as follows: heterogeneous hyperechoic node (twisted testicular appendage) between testis and head of epididymis (45 cases),the nodes with no blood flow signal (42 cases),enlargement of testis and epididymis with increased blood flow signals (41 cases),hydroceles (31cases) and thickness of the wall of scrotum (39 cases). In 48 cases,the accuracy of sonographic diagnosis was 93.5% (45/48).Conclusions Hyperechoic node with no blood flow found between testes and head of epididymis is the specific sonographic appearance of torsion of tesicular appendage.With high accuracy,color Doppler sonography can be used as an optimal method to diagnose the disease.