本文關(guān)鍵詞：高頻彩超對(duì)小兒陰囊急癥的診斷及鑒別診斷價(jià)值　出處：《中華男科學(xué)雜志》2016年11期 　論文類型：期刊論文

  更多相關(guān)文章： 超聲檢查 高頻彩超 陰囊急癥 睪丸扭轉(zhuǎn) 小兒

【摘要】：目的:分析小兒陰囊急癥的高頻超聲圖像特征,探討高頻彩超對(duì)小兒陰囊急癥的診斷及鑒別診斷價(jià)值。方法:回顧分析我院2014年1月至2016年1月因陰囊急癥而行彩色多普勒血流顯像(CDFI)檢查的256例患兒(起病時(shí)間2 h至3 d,年齡2 d至14歲)睪丸的形態(tài)、結(jié)構(gòu)、內(nèi)部回聲及血供情況,并與臨床手術(shù)及病理結(jié)果進(jìn)行對(duì)照分析比較。結(jié)果:256例陰囊急癥患兒中急性睪丸扭轉(zhuǎn)23例,其中16例患兒行壞死睪丸切除術(shù),有12例行對(duì)側(cè)睪丸固定術(shù);7例患兒行扭轉(zhuǎn)睪丸復(fù)位,予保留并行睪丸固定術(shù)。超聲特征:患兒患側(cè)睪丸不同程度增大或縮小,內(nèi)部回聲不均勻,可見不規(guī)則片狀低回聲,可伴有睪丸鞘膜積液。CDFI:患側(cè)睪丸內(nèi)無(wú)明顯血流信號(hào),周圍血流信號(hào)豐富。急性睪丸附件扭轉(zhuǎn)116例,超聲特征:睪丸上極上方或睪丸上極與附睪頭間類圓形或橢圓形異�；芈暯Y(jié)節(jié),早期為低回聲,后逐漸增高,內(nèi)部回聲不均勻,呈"網(wǎng)格樣"。附睪增大,可伴有患側(cè)睪丸增大、陰囊壁增厚。CDFI:增大附睪或睪丸血流豐富,結(jié)節(jié)內(nèi)未見血流信號(hào)。急性附睪炎103例,超聲特征:患兒患側(cè)附睪明顯不同程度腫大,內(nèi)部回聲不均勻,CDFI:患側(cè)附睪內(nèi)血流信號(hào)豐富。急性睪丸炎6例,超聲特征:患側(cè)睪丸腫大,內(nèi)部回聲呈低回聲,回聲尚均勻。CDFI:患側(cè)睪丸內(nèi)部血流豐富。腹股溝嵌頓疝15例,超聲特征:可見疝囊突入陰囊,陰囊明顯增大,其內(nèi)可見腸系膜及腸管。CDFI:可見血流信號(hào)。急性陰囊壁血腫及水腫8例。超聲特征:陰囊壁均勻或不均勻增厚。CDFI;陰囊壁可見血流信號(hào)。結(jié)論:高頻彩超對(duì)小兒陰囊急癥具有較高敏感性及特異性,可為臨床醫(yī)生診斷及鑒別診斷提供可靠的診斷依據(jù),是臨床首選的影像學(xué)檢查方法。
[Abstract]:Objective: to analyze the characteristics of high frequency ultrasound images of the children's scrotum emergency, and to explore the value of high frequency color Doppler ultrasound in the diagnosis and differential diagnosis of the acute scrotum of children. Methods: a retrospective analysis of our hospital from January 2014 to January 2016 due to acute scrotum and color Doppler flow imaging (CDFI) in 256 cases (check the onset time from 2 h to 3 D D, aged 2 to 14 years old) for testicular morphology, structure, internal echo and blood, and were compared with surgery and pathology results. Results: in 256 cases of acute scrotum, 23 cases had acute testicular torsion, 16 of them underwent necrotic orchiectomy, 12 had contralateral testicular fixation, 7 children underwent torsion testicular reduction, and the other two were reserved for testicular fixation. Ultrasonic features: the children's testicles were enlarged or narrowed in varying degrees. The internal echoes were uneven, and the irregular flaky low echo could be seen with the hydrocele of the testicle. There was no obvious blood flow signal in the testicle of CDFI:, and the peripheral blood flow signal was rich. Acute testicular appendage torsion in 116 cases. Ultrasonographic features: round or oval abnormal echo nodules above the top of testis or above the epididymal head, early hypoechoic, gradually increased and internal echo uneven. The enlargement of epididymis can be accompanied by enlarged testis of the affected side and thickening of the scrotum wall. CDFI: increased the blood flow of epididymis or testis, and no blood flow signals were found in the nodules. 103 cases of acute epididymitis, ultrasound features: children with ipsilateral epididymis obvious swelling, uneven internal echo, CDFI: ipsilateral epididymis rich blood flow signal. 6 cases of acute orchitis, ultrasonographic features: enlarged testis in the affected side, hypoechoic internal echo and homogeneous echo. CDFI: is rich in blood flow inside the testis. 15 cases of inguinal incarcerated hernia were characterized by ultrasonic features: the hernia sac was seen into the scrotum, the scrotum was obviously enlarged, and the mesenteric and enteric tubes were visible. The blood flow signal was seen in CDFI:. Acute scrotal hematoma and edema were found in 8 cases. Ultrasonic features: uniform or uneven thickening of the wall of the scrotum. CDFI; the blood flow signals are visible on the wall of the scrotum. Conclusion: high frequency color Doppler ultrasound is highly sensitive and specific for children with scrotum emergencies. It can provide reliable diagnostic basis for clinicians in the diagnosis and differential diagnosis, and is the preferred imaging examination method in clinical practice.
【作者單位】： 上海交通大學(xué)附屬兒童醫(yī)院/上海市兒童醫(yī)院超聲科;上海交通大學(xué)附屬兒童醫(yī)院/上海市兒童醫(yī)院泌尿外科;
【基金】：上海市公共衛(wèi)生體系建設(shè)三年行動(dòng)計(jì)劃(2012001685)~~
【分類號(hào)】：R445.1;R726.9
【正文快照】： sion was found in 116 cases,in which ultrasonography manifested nodules with round or oval abnormal echoes between the upper poleof the testis and caput epididymidis,first hypoechoic and then gradually increased,heterogeneous internally.CDFI revealed enl，

本文編號(hào)：1341802