超声造影及定量分析在不完全睾丸扭转诊断中的价值  

Value of contrast-enhanced ultrasound and quantitative analysis in diagnosis of incomplete testicular torsion

作　　者：李业钊[1] 陈昭蓓 张霞[1] 廖海珍[1] 覃敏培 谭臻[1] 黄艳焦 苏海庆[1] LI Yezhao;CHEN Zhaobei;ZHANG Xia;LIAO Haizhen;QIN Minpei;TAN Zhen;HUANG Yanjiao;SU Haiqing(Department of Ultrasound,National Hospital Affiliated to Guangxi Medical University,Nanning 530001,China)

机构地区：[1]广西医科大学附属民族医院暨广西壮族自治区民族医院超声学科

出　　处：《实用医学杂志》2020年第3期395-399,共5页The Journal of Practical Medicine

基　　金：广西医科大学青年科学基金项目(编号：GXMUYSF201817)

摘　　要：目的通过与高频彩超对比,探讨超声造影及定量分析在不完全睾丸扭转诊断中的临床价值。方法回顾性分析52例经临床随访或手术证实的不完全睾丸扭转患者的超声造影图像,与高频彩超的诊断性能进行比较,并分析健患两侧睾丸实质造影剂到达时间(AT)、达峰时间(TTP)、峰值强度(PI)、流出时间(WT)。结果超声造影时,52例不完全睾丸扭转患者睾丸实质内部均可见分布不均匀的造影剂填充,回声强度低于健侧,部分可见造影剂局部缺损区。超声造影诊断不完全睾丸扭转的准确率为100%,高频彩超诊断不完全睾丸扭转的准确率为86.5%,两种方法统计学比较差异有统计学意义(χ2=4.73,P<0.05)。患侧睾丸实质时间强度曲线(TIC)呈“慢上慢下型”,健侧睾丸实质TIC呈“快上快下型”,健患两侧睾丸实质造影剂的PI和WT两两比较差异有统计学意义(P<0.001)。通过ROC曲线,确定PI值16.13 dB和WT值125.36 s为诊断的最佳临界点,有很好的敏感性和特异性。结论超声造影诊断不完全睾丸扭转的准确率与高频彩超不同,超声造影的诊断率较高,通过超声造影定量分析可根据PI和WT值判断有无不完全睾丸扭转,这可为临床医生准确诊断不完全睾丸扭转提供量化影像学信息,减少评估的主观性。Objective To explore the clinical value of contrast⁃enhanced ultrasound(CEUS)and quanti⁃tative analysis in the diagnosis of incomplete testicular torsion by contrasting with the effect of high frequency color Doppler ultrasound.Methods Fifty⁃two patients with incomplete testicular torsion that were confirmed by clinical follow⁃up or surgery were recruited.We retrospectively analyzed CEUS image characteristics,and the diagnostic performance was compared with that of high frequency color Doppler ultrasound.CEUS quantitative analysis param⁃eters including arrival time(AT),time to peak(TTP),peak intensity(PI)and wash time(WT)of both healthy side testis and affected side testis were compared.Results In CEUS,contrast agent inhomogeneous flowed in affected testis of these 52 incomplete testicular torsion patients,with local defect area,echo intensity was lower than that in healthy side.Accuracy rate of CEUS in the diagnosis of incomplete testicular torsion was 100%,and that of high frequency color Doppler ultrasound 86.5%,which was statistically significant(χ2=4.73,P<0.05).The time⁃intensity curve of affected testis showed slow⁃up slow⁃down tendency but that of healthy testis had quick⁃up quick⁃down tendency.PI and WT were statistically significant between healthy testis and affected testis(P<0.001).Receiver Operating Characteristic(ROC)curve indicated PI values of 16.13dB and WT values of 125.36s were confirmed as the optimal critical points for diagnosis,with good sensitivty and speficity.Conclusion The accuracy of CEUS in the diagnosis of incomplete testicular torsion is different from that of high⁃frequency color Doppler ultrasound,and the diagnostic rate of the former is higher.With PI and WT value,the quantitative analysis parameters of CEUS is helpful for the diagonsis,which could reduce the subjectivity of the assessment and provide quantitative information for clinicians.

关 键 词：不完全睾丸扭转 高频彩超 超声造影 定量分析 

分 类 号：R697[医药卫生—泌尿科学]