高频超声联合彩色多普勒血流成像对阴茎损伤的分型价值  

The clinical value of high frequency ultrasound combined with color Doppler flow imaging in diagnosis and classification of trauma of penis

作　　者：梁荣喜[1] 薛恩生[1] 叶琴[1] 林晓东[1] 林文金[1] 陈舜[1] Liang Rongxi;Xue Ensheng;Ye Qin;Lin Xiaodong;Lin Wenjin;Chen Shun(Department of Ultrasound,Union Hospital,Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院超声科,福州350001

出　　处：《中华超声影像学杂志》2019年第7期625-628,共4页Chinese Journal of Ultrasonography

基　　金：福建省教育厅科技项目(JA15220).

摘　　要：目的探讨高频超声联合彩色多普勒血流成像对不同程度阴茎损伤的声像分型及其在治疗中的指导价值.方法对48例阴茎损伤的声像图特征进行分型,并与临床治疗转归进行对照分析.结果阴茎损伤的超声表现从皮下组织挫伤至阴茎断裂不等.依不同损伤程度及相应的声像表现分型为:Ⅰ型,皮下组织挫伤(7例):阴茎皮肤及白膜回声连续,皮下组织回声不均匀;Ⅱ型,海绵体挫伤(4例):白膜回声连续,海绵体内见回声不均区,内无血流信号,伴海绵体动脉损伤时,海绵体肿胀呈筛窦状,局部见低-无回声区,可测及高速动脉血流信号.Ⅰ型和Ⅱ型患者行保守治疗.Ⅲ型,皮肤、皮下组织挫裂伤(6例):皮肤、皮下组织局部连续性中断,回声不均匀,海绵体及白膜回声均匀,行保守或清创缝合治疗.Ⅳ型,海绵体白膜破裂(26例):海绵体白膜回声连续性中断,断口旁、阴茎皮下见回声不均区,内无血流信号;Ⅴ型,阴茎断裂(5例):皮肤、海绵体及白膜大部分或全部离断,常伴有阴茎血管断裂.Ⅳ型和Ⅴ型患者行手术治疗.结论彩色多普勒超声检查可对不同程度的阴茎损伤超声表现进行准确评估及声像分型,为临床治疗方案的制定提供重要的参考依据.Objective To investigate the value of high frequency ultrasound combined with color Doppler flow imaging in diagnosis and classification of trauma of penis on the clinical treatment. Methods The sonographic features of 48 cases with penile trauma were analyzed and compared with treatment outcomes. Results The ultrasonic findings of penile trauma ranged from penis contusion to penis fracture. According to the sonographic features, the trauma of penis was grouped as follows: Type 1, penis bruise (7 cases) presented with images of continuous penis skin and tunica albuginea, inhomogeneous echoes of subcutaneous tissue. Type 2, corpora cavernosa bruise (4 cases) showed images of continuous tunica albuginea, inhomogeneous internal echoes of corpora cavernosa without abnormal flow signal. The corpora cavernosa swelling into honeycomb-like, anechoic area of cavernosa with high-speed artery Doppler signals when accompanied by cavernous artery injury. Four cases were treated conservatively. Type 3, the skin and subcutaneous tissue contusion (6 cases) manifested images of incontinuous and inhomogeneous echoes of skin and subcutaneous tissue but homogeneous echoes of corpora cavernosa and tunica albuginea. Six cases of patients underwent debridement and sutured by local anesthesia. Type 4, rupture of tunica albuginea(26 cases) revealed images of incontinuous and irregular local tunica albuginea, a hematoma seen between the tunica albuginea and subcutaneous tissue. Type 5, penile fracture (5 cases) revealed mostly or fully disconnected skin and corpora cavernosa, tearing of blood vessels. The patients of type 4 and 5 were all treated surgically. Conclusions Color Doppler ultrasonography could provide accurate assessment and classification for trauma of penis, which is helpful to offer a reliable basis for clinical treatment scheme.

关 键 词：超声检查 阴茎 破裂 外伤 

分 类 号：R445.1[医药卫生—影像医学与核医学]