彩色多普勒超声在小儿睾丸扭转诊断中的应用  

Clinical Application of Color Doppler Ultrasound in Testicular Torsion in Children

作　　者：陈晨 葛怡辰 胡春峰 Chen Chen;Ge Yichen;Hu Chunfeng(Department of Ultrasound Medicine,Xuzhou Children’s Hospital Affiliated to Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Nanjing Medical University,Nanjing,Jiangsu 210011,China;Department of Medical Imaging,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属徐州儿童医院超声医学科,江苏省徐州市221000 [2]南京医科大学,江苏省南京市210011 [3]徐州医科大学附属医院医学影像科,江苏省徐州市221000

出　　处：《中国超声医学杂志》2022年第3期329-332,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的研究彩色多普勒超声(CDUS)在小儿睾丸扭转诊断中的应用。方法回顾性收集56例睾丸扭转患儿为睾丸扭转组,急性附睾炎患儿40例为对照组。将睾丸扭转患儿根据活力、扭转度数和发病时间分成亚组,收集患儿临床、声像图特征。结果超声诊断56例睾丸扭转患儿52例,诊断准确率为95.83%(92/96),灵敏度为92.86%(52/56),漏诊率为7.14%(4/56),特异度为100.00%(40/40)。与对照组比,睾丸扭转组的Arda评分差异存在统计学意义(P<0.05)。与有活力亚组比,无活力亚组年龄较小,病程较长,扭转度数较大(P<0.05),两组患侧及健侧的睾丸体积、患健侧体积比差异无统计学意义(P>0.05)。与≤360°亚组比,>360°亚组年龄较小,病程较长,Arda评分较高(P<0.05),两亚组的患侧及健侧的睾丸体积、患健侧体积比差异无统计学意义(P>0.05)。与≤24 h亚组比,>24 h亚组的年龄较小,Arda评分较高(P<0.05),两亚组的患侧及健侧的睾丸体积、患健侧体积比差异无统计学意义(P>0.05)。超声显示,左侧42例,右侧14例。患侧睾丸增大或缩小,内部回声不均匀,14例患侧睾丸回声升高,42例患侧睾丸回声降低。彩色多普勒血流图像(CDFI):12例睾丸内部及周边可见较丰富血流信号,23例患侧睾丸内部血流信号明显减少;21例患侧睾丸内无明显血流信号,其中5例睾丸回声减低,3例睾丸内见裂隙样低回声,带有多个低回声线,睾丸内无明显血流信号。睾丸扭转患儿均接受手术治疗。结论年龄小、持续时间较长、扭转度数大的睾丸扭转患儿病情较严重,睾丸失活率高,应尽早诊治。CDUS对小儿睾丸扭转具有较高的诊断价值。Objective To study the clinical application of color Doppler ultrasound(CDUS)in testicular torsion in children.Methods 56 children with testicular torsion were selected as testicular torsion group and 40 children with acute epididymitis were selected as control group.The children with testicular torsion were divided into subgroups based on the vitality,torsion angle and onset time.The clinical and ultrasound image features and pathological results in each group or subgroups were analyzed.Results 52 cases of 56 children with testicular torsion were diagnosed by ultrasound.The accuracy of ultrasonic differential diagnosis of testicular torsion was 95.83%(92/96),the sensitivity was 92.86%(52/56),the missed diagnosis rate was 7.14%(4/56)and the specificity was 100.00%(40/40).Compared with the control group,the Arda scores in the testicular torsion group was statistically significant(P<0.05).Compared with the active subgroup,the inactive subgroup was younger,had a longer course of disease and a greater degree of torsion(P<0.05).There were no significant differences in testicular volume and the ratio of testicular volume to the affected side and the healthy side between the two group(P>0.05).Compared with the≤360°subgroup,the>360°subgroup had a younger age,a longer course of disease and a higher Arda score(P<0.05).There were no significant differences in testicular volume and the ratio of testicular volume to the affected side and the healthy side between the two group(P>0.05).Compared with the≤24 h subgroup,the>24 h subgroup had a younger age and a higher Arda score(P<0.05).There were no significant differences in testicular volume and the ratio of testicular volume to the affected side and the healthy side between the two group(P>0.05).Ultrasound showed 42 cases on the left and 14 cases on the right.The testicle on the affected side increased or decreased,and the internal echo was not uniform.The echo on the affected side testis increased in 14 cases,and decreased in 42 cases.The color Doppler flow image(CDFI)e

关 键 词：超声 睾丸扭转 小儿 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.9[医药卫生—诊断学]