高频彩超对小儿阴囊急症的诊断及鉴别诊断价值

发布时间：2017-12-27 13:03

  本文关键词：高频彩超对小儿阴囊急症的诊断及鉴别诊断价值　出处：《中华男科学杂志》2016年11期 　论文类型：期刊论文

  更多相关文章： 超声检查 高频彩超 阴囊急症 睾丸扭转 小儿

【摘要】：目的:分析小儿阴囊急症的高频超声图像特征,探讨高频彩超对小儿阴囊急症的诊断及鉴别诊断价值。方法:回顾分析我院2014年1月至2016年1月因阴囊急症而行彩色多普勒血流显像(CDFI)检查的256例患儿(起病时间2 h至3 d,年龄2 d至14岁)睾丸的形态、结构、内部回声及血供情况,并与临床手术及病理结果进行对照分析比较。结果:256例阴囊急症患儿中急性睾丸扭转23例,其中16例患儿行坏死睾丸切除术,有12例行对侧睾丸固定术;7例患儿行扭转睾丸复位,予保留并行睾丸固定术。超声特征:患儿患侧睾丸不同程度增大或缩小,内部回声不均匀,可见不规则片状低回声,可伴有睾丸鞘膜积液。CDFI:患侧睾丸内无明显血流信号,周围血流信号丰富。急性睾丸附件扭转116例,超声特征:睾丸上极上方或睾丸上极与附睾头间类圆形或椭圆形异常回声结节,早期为低回声,后逐渐增高,内部回声不均匀,呈"网格样"。附睾增大,可伴有患侧睾丸增大、阴囊壁增厚。CDFI:增大附睾或睾丸血流丰富,结节内未见血流信号。急性附睾炎103例,超声特征:患儿患侧附睾明显不同程度肿大,内部回声不均匀,CDFI:患侧附睾内血流信号丰富。急性睾丸炎6例,超声特征:患侧睾丸肿大,内部回声呈低回声,回声尚均匀。CDFI:患侧睾丸内部血流丰富。腹股沟嵌顿疝15例,超声特征:可见疝囊突入阴囊,阴囊明显增大,其内可见肠系膜及肠管。CDFI:可见血流信号。急性阴囊壁血肿及水肿8例。超声特征:阴囊壁均匀或不均匀增厚。CDFI;阴囊壁可见血流信号。结论:高频彩超对小儿阴囊急症具有较高敏感性及特异性,可为临床医生诊断及鉴别诊断提供可靠的诊断依据,是临床首选的影像学检查方法。
[Abstract]:Objective: to analyze the characteristics of high frequency ultrasound images of the children's scrotum emergency, and to explore the value of high frequency color Doppler ultrasound in the diagnosis and differential diagnosis of the acute scrotum of children. Methods: a retrospective analysis of our hospital from January 2014 to January 2016 due to acute scrotum and color Doppler flow imaging (CDFI) in 256 cases (check the onset time from 2 h to 3 D D, aged 2 to 14 years old) for testicular morphology, structure, internal echo and blood, and were compared with surgery and pathology results. Results: in 256 cases of acute scrotum, 23 cases had acute testicular torsion, 16 of them underwent necrotic orchiectomy, 12 had contralateral testicular fixation, 7 children underwent torsion testicular reduction, and the other two were reserved for testicular fixation. Ultrasonic features: the children's testicles were enlarged or narrowed in varying degrees. The internal echoes were uneven, and the irregular flaky low echo could be seen with the hydrocele of the testicle. There was no obvious blood flow signal in the testicle of CDFI:, and the peripheral blood flow signal was rich. Acute testicular appendage torsion in 116 cases. Ultrasonographic features: round or oval abnormal echo nodules above the top of testis or above the epididymal head, early hypoechoic, gradually increased and internal echo uneven. The enlargement of epididymis can be accompanied by enlarged testis of the affected side and thickening of the scrotum wall. CDFI: increased the blood flow of epididymis or testis, and no blood flow signals were found in the nodules. 103 cases of acute epididymitis, ultrasound features: children with ipsilateral epididymis obvious swelling, uneven internal echo, CDFI: ipsilateral epididymis rich blood flow signal. 6 cases of acute orchitis, ultrasonographic features: enlarged testis in the affected side, hypoechoic internal echo and homogeneous echo. CDFI: is rich in blood flow inside the testis. 15 cases of inguinal incarcerated hernia were characterized by ultrasonic features: the hernia sac was seen into the scrotum, the scrotum was obviously enlarged, and the mesenteric and enteric tubes were visible. The blood flow signal was seen in CDFI:. Acute scrotal hematoma and edema were found in 8 cases. Ultrasonic features: uniform or uneven thickening of the wall of the scrotum. CDFI; the blood flow signals are visible on the wall of the scrotum. Conclusion: high frequency color Doppler ultrasound is highly sensitive and specific for children with scrotum emergencies. It can provide reliable diagnostic basis for clinicians in the diagnosis and differential diagnosis, and is the preferred imaging examination method in clinical practice.
【作者单位】： 上海交通大学附属儿童医院/上海市儿童医院超声科;上海交通大学附属儿童医院/上海市儿童医院泌尿外科;
【基金】：上海市公共卫生体系建设三年行动计划(2012001685)~~
【分类号】：R445.1;R726.9
【正文快照】： sion was found in 116 cases,in which ultrasonography manifested nodules with round or oval abnormal echoes between the upper poleof the testis and caput epididymidis,first hypoechoic and then gradually increased,heterogeneous internally.CDFI revealed enl，

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