灰阶超声及彩色多普勒超声在儿童阴囊急症鉴别诊断中的应用  

Differentiation Diagnosis of Acute Scrotum Diseases in Children with Gray Scale Sonography and Color Doppler Sonography

作　　者：张丽娥[1] 张玉林[1] 苏英姿[1] 王峥嵘[1] 崔彦春[1] 

机构地区：[1]首都儿科研究所附属儿童医院超声科,北京100020

出　　处：《中国医药导刊》2009年第7期1089-1091,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨灰阶超声及彩色多普勒超声检查在鉴别诊断儿童阴囊急症中的作用。方法:回顾性分析了108例患儿的117个急性病变的阴囊,将其分为3组:睾丸扭转(12个)。睾丸附件扭转(76个),附睾炎和(或)睾丸炎(29个)。对下列灰阶及彩色多普勒影像特征进行分析:阴囊壁水肿,睾丸肿胀,睾丸实质回声不匀,附睾增大,睾丸外结节,鞘膜积液,睾丸内血流分布(正常、增多、减少或消失)及精索扭转。结果:与睾丸扭转相关的声像图特征是睾丸肿胀、睾丸实质回声不匀、睾丸内血流分布减少或消失及精索扭转;与睾丸附件扭转相关的特征为附睾与睾丸之间的小结节、正常的睾丸形态实质回声及血供:与附睾睾丸炎相关的特征是病灶内血流分布明显增多(以上三组比较有显著性差异P<0.01)。阴囊壁水肿、附睾增大及鞘膜积液等声像图表现是急性阴囊疾病共有的特征,无统计学意义(P>0.05)。结论:灰阶超声及彩色多普勒超声可以帮助鉴别诊断儿童阴囊急症。Objective：To determine whether acute scrotum diseases in children can be differentiated by gray scale sonographic and color Doppler sonographic features or not. Methods：117 acute scrotums diseases in 108 boys were retrospectively analyzed.Acute scrotums diseases in children were classified into 3 groups： testicular torsion （n=12）, torsion of testicular appendix （n=76）,and epididymoorchitis （n=29）.The following gray scale sonographie and color Doppler sonographic features were analyzed： scrotal wall edema, swollen testis, testicular parenchyma architecture heterogeneity, enlarged epididymis, extratesticular nodule,hydrocele presence,blood flow in testis（normal,increased, decreased or absent） and coiled spermatic cord. Results：Logistic regression showed sonographic features of swollen testis,testicular parenchyma architecture heterogeneity, blood flow decreased or absent in testis and coiled spermatic cord were most significantly associated with torsion（P〈0.01）.The extratesticular nodule,normal parenchyma and blood flow in testis were most significantly associated with torsion of testicular appendix（ P〈0.01）.The increased blood flow in testis was most significantly associated with epididymo-orchitis（ P〈0.01）.Sonographic features of scrotal wall edema, enlarged epididymis and hydrocele were not significantly associated with differential diagnosis of acute scrotum（P〉0.05）. Conclusions：Gray scale sonographie and color Doppler sonographic may be helpful in differentiation diagnosis of acute scrotum diseases in children.

关 键 词：彩色多普勒超声检查 阴囊急症 睾丸扭转 睾丸附件 附睾炎或睾丸炎 

分 类 号：R726.9[医药卫生—儿科] R445.1[医药卫生—临床医学]