出生24小时内新生儿睾丸扭转的超声诊断意义  

Diagnostic significance of ultrasonography in neonatal testicular torsion within 24 hours after birth

作　　者：周蕾[1] 李世杰[1] 同俊仪[1] 张旗[1] 张慧[1] 

机构地区：[1]西安市第四医院超声科,陕西西安710004

出　　处：《中国妇幼健康研究》2015年第4期738-740,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨出生24小时内新生儿睾丸扭转的声像图特点及临床意义。方法分析5例新生儿睾丸扭转病例的二维超声及彩色多普勒超声的声像图特点,并与手术及病理结果相比较。结果睾丸扭转二维声像图的特异性表现为睾丸内回声增强或减弱,有放射状的裂隙样改变;彩色多普勒血流特异性表现为睾丸内无血流信号,扭转以下精索内无血流信号,睾丸周围可见彩色血流信号,呈"环岛征"。本组5例患儿均在出生24小时以内检出睾丸扭转;其中2例为双侧睾丸扭转,2例为左侧睾丸扭转,1例为右侧睾丸扭转;其中1例双侧睾丸扭转的患儿在胎儿期孕39周超声检查已经检出睾丸回声异常,生后证实双侧睾丸扭转(其中一侧睾丸已经萎缩坏死)。出生后超声诊断与手术病理结果诊断符合率100%。结论出生后24小时内新生儿睾丸扭转,需急诊行新生儿阴囊彩超检查,对挽救新生儿睾丸有着至关重要的作用。同时出生后24小时内新生儿睾丸扭转,其部分患儿在胎儿期已经发生睾丸扭转。Objective To study the ultrasonographic characteristics and their clinical significance of neonatal testicular torsion within 24 hours after birth.Methods The features of two-dimensional ultrasonography and color Doppler ultrasound of 5 cases of testicular torsion were analyzed, and they were compared with the results of surgery and pathology.Results The two-dimensional ultrasonographic specificity of testicular torsion was manifested with hypoechoic or hyperechoic with radial distribution.Color Doppler flow specific performance included no blood flow signal in testis, no blood flow signal in spermatic cord below torsion, and＂island ring＂ color flow signal around testis.Testicular torsion was found within 24 hours after birth in 5 cases, including 2 cases of bilateral testicular torsion, 2 cases of left testicular torsion and 1 case of right testicular torsion.One of the cases with bilateral testicular torsion was detected with abnormal echo at gestational 39 weeks, and it was confirmed after birth （ one testicle was atrophic and necrostic ） .The coincidence rate of ultrasound diagnosis and surgical pathology after birth was 100%.Conclusion The neonatal testicular torsion within 24 hours after birth needs emergency treatment of neonatal scrotum color Doppler ultrasound examination, which has a vital role in saving neonatal testis.At the same time, some of testicular torsion of the newborns detected within 24 hours after birth may occur in fetal stage.

关 键 词：睾丸扭转 新生儿 超声诊断 出生24小时内 

分 类 号：R722.1[医药卫生—儿科]