术前超声预判儿童睾丸扭转后不同转归

发布时间：2018-07-03 11:57

  本文选题：超声检查 + 儿童　； 参考：《中国医学影像技术》2015年08期

【摘要】：目的探讨术前超声预判睾丸扭转患儿转归的应用价值。方法回顾性分析45例儿童睾丸扭转的临床及超声资料。按不同转归分为存活组(手术复位后随访睾丸存活)及失睾组(因缺血、坏死接受患侧睾丸切除术或手术复位后随访患侧睾丸萎缩),对比观察两组声像图特征,包括患侧睾丸大小改变、轴向改变、内部回声、血流改变及鞘膜积液。并进行统计学分析,选取组间差异有统计学意义的声像图特征,建立Logistic回归模型预判患侧睾丸转归。结果 45例患儿均为单侧扭转,其中左侧27例,右侧18例;最终纳入存活组11例,失睾组34例。失睾组34例中,32例患侧睾丸回声不均匀,2例回声尚均匀;33例患侧睾丸实质内未探及血流信号,1例探及少量血流信号;6例患侧睾丸周边可见"环岛"征。存活组11例中,9例睾丸实质内回声均匀,2例回声不均匀;9例患侧睾丸实质内血流较健侧减少,2例未探及血流信号。两组间内部回声及血流改变差异有统计学意义(P均0.05),患侧睾丸大小改变、轴向改变及鞘膜积液差异均无统计学意义(P均≥0.05)。Logistic回归模型结果显示,术前超声的阳性(失睾)预测值为97.10%,阴性(存活)预测值为81.80%,预判睾丸扭转患儿转归的准确率为93.30%。结论术前超声对预判儿童睾丸扭转的转归具有较高准确率,声像图中患侧睾丸内部回声及血流改变可作为预判指标。
[Abstract]:Objective to evaluate the value of preoperative ultrasonography in predicting the outcome of testicular torsion in children with testicular torsion. Methods the clinical and ultrasonic data of 45 children with testicular torsion were analyzed retrospectively. According to the different outcomes, the patients were divided into survival group (survival of testis after surgical reduction) and denervated testis group (with ischemic, necrotic or postoperative testicular atrophy). The sonographic features of the two groups were compared and observed. These include changes in the size of the affected testis, axial changes, internal echoes, changes in blood flow, and hydrocele. Statistical analysis was carried out, and the characteristics of sonogram with statistically significant differences were selected, and logistic regression model was established to predict the outcome of the affected testis. Results all 45 cases were unilateral torsion, including 27 cases left and 18 cases right, and 11 cases were included in survival group and 34 cases in denervated testis group. There were 32 cases of testicular heterogeneity and 32 cases of testicular heterogeneity. 33 cases had no blood flow signal in the affected side testicular parenchyma and 6 cases had "ring island" sign around the affected side testis. In the survival group, 9 cases had homogenous echo in testis parenchyma and 2 cases had uneven echo. 9 cases had less blood flow in the affected side than in the normal side, 2 cases had not detected the blood flow signal. There were significant differences in internal echo and blood flow between the two groups (all P 0.05). There was no significant difference in testicular size, axial change and hydrocele between the two groups (P 鈮，

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