附睾结核的超声分型及其应用价值  

Clinical value of uitrasonography in typing epididymal tuberculosis

作　　者：成瑞明[1] 刘罩明[1] 张铭[1] 徐静[1] 

机构地区：[1]天津市海河医院超声科国家中医药管理局中医药防治传染病重点研究室,300350

出　　处：《中华超声影像学杂志》2016年第2期163-167,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨附睾结核的超声分型及其在治疗中的指导价值。方法对125例附睾结核患者的声像图特征及治疗转归进行分析。结果125例附睾结核中弥漫型37例，声像图表现附睾弥漫性增大，形态不规则，表面不光滑，内部回声不均匀减低，13例保守治疗，24例保守治疗无效后接受手术治疗；肿块型24例，声像图表现附睾尾部或头部低回声肿块，4例手术治疗，20例保守治疗；脓肿型33例，声像图表现为附睾头尾部的不规则液性无回声区，内透声差，边界模糊;溃疡瘘管型9例，声像图表现为附睾头部或尾部液性弱回声，通向阴囊表面；睾丸受累型22例，肿大的睾丸内可见不均质低回声团块，边界不清。脓肿型、溃疡瘘管型及睾丸受累型全部接受手术治疗。结论附睾结核的超声分型可以为临床治疗方案的选择提供有力依据，值得推广。Objective To investigate the value of ultrasound in typing of epididymal tuberculosis on the clinical treatment. Methods The sonographic characteristics and treatment outcomes were analyzed in 125 patients with epididymal tuberculosis. Results In 125 patients with epididymal tuberculosis, 5 types were divided： （1） Diffusive type （37 cases） presented images of the epididymal diffuse enlargement, abnormal shape, not smooth surface and inhomogeneous reduced in echogenicity, 13 cases were treated conservatively and 24 cases underwent surgical treatment after failure of conservative treatment. （2） Mass type （24 cases） showed images of hypoechoic mass lesion of caput epididymidis or cauda epididymidis, 4 cases were treated with surgical operation and 20 cases were treat with conservative therapy. （3） Abscess type （33 cases） manifested images of irregular liquid anechoic of caput epididymidis and cauda epididymidis, poor ultrasound penetration,and unclear border. （4） Ulcer-fistula type （9 cases） revealed images of liquid hypoechoic caput epididymidis or cauda epididymidis extend to the surface of the scrotum. （5） Testicular involvement type （22 cases） detected inhomogeneous hypoechoic mass lesion within the testicle and unclear border. The patients of abscess type, ulcer-fistula type and testicular involvement type were all treated surgically. Conclusions Ultrasonic diagnosis of epididymal tuberculosis provided a reliable basis for clinical treatment scheme and it was worth recommending.

关 键 词：超声检查 附睾 结核 

分 类 号：R445.1[医药卫生—影像医学与核医学] R527.4[医药卫生—诊断学]