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目的探讨磁共振成像(magnetic resonance imaging,MRI)与彩色多普勒超声在急性阴囊闭合性损伤中的诊断价值。方法收集急性阴囊闭合性损伤患者8例,所有病例全部经MRI及彩色多普勒超声检查,回顾性分析及比较MRI及彩色多普勒超声图像。结果8例急性阴囊闭合性损伤患者中,MRI示睾丸损伤出血8例(其中自膜下少量积血2例),睾丸增大、阴囊肿大皮肤增厚、鞘膜积液8例,白膜毛糙3例,附睾增大5例(其中附睾损伤出血3例),腹股沟区淋巴结肿大4例。彩色多普勒超声示睾丸损伤出血6例,睾丸增大6例,阴囊肿大、皮肤增厚8例,鞘膜积液6例,白膜异常未见,附睾增大2例,腹股沟区淋巴结肿大未见。结论MRI能清楚显示急性阴囊闭合性损伤,是目前诊断急性阴囊闭合性损伤的精确影像检查方法。 相似文献
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目的 :探讨MRI对阴囊及其内容物闭合性损伤的诊断价值。方法 :对 11例急性、亚急性阴囊闭合性损伤患者 ,行MRSET1WI、FSET2 WI横断面、冠状面、矢状面扫描。结果 :阴囊增大皮肤增厚 9例 ,鞘膜积液 10例 ,白膜下血肿 3例 ,睾丸挫伤出血 8例 ,睾丸白膜破裂 3例 ,外伤后睾丸萎缩 2例。结论 :MRI是检查阴囊闭合性损伤 ,诊断睾丸受伤程度及疗效评价精确的影像学检查方法。 相似文献
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于满 《国外医学:临床放射学分册》1993,(4)
作者对钝性阴囊创伤伴有睾丸挫伤而无血肿的17例病人作了US估价。年龄4~40岁,受伤前阴囊无异常病史。病人均用7.5MHz的US探头进行阴囊实时US扫描,非手术治疗的病人用US随访。结果表明,除1例阴囊发炎和水肿妨碍触诊外,其余病人均能触及睾丸,9例睾丸附睾触之正常,但US检出睾丸白膜下血肿2例,实质挫伤2例,附睾炎2例,无1例需手术,均采取保守治疗。其余7例触之睾丸附睾形态上有改变,US显示附睾炎1例,附睾血肿1例,白膜下血肿1例,睾丸挫伤4例,其中有2例白膜破裂。这7例中有5例手术治疗,其中2例血肿清除,2例坏死的睾丸小管清创 相似文献
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由于阴囊的保护作用及睾丸的游动性较大 ,外伤性睾丸挫裂伤的发生率较低 ,但由于武警战士训练的特殊性 ,使睾丸闭合性损伤的发生率近年来明显增高。我院自 1990年共收治训练致睾丸挫裂伤 11例 ,现报告如下。1 临床资料本组 11例 ,年龄 18~ 2 2岁 ,均为单侧闭合性睾丸挫裂伤 ,右侧 6例 ,左侧 5例。致伤原因包括单杠 1例 ,双杠 3例 ,跳马 2例 ,踢、打伤 5例 ,均有不同程度的阴囊血肿。B超检查共 6例 ,4例诊断为睾丸破裂 ,2例诊断为阴囊血肿。CT检查 3例诊断为睾丸破裂。 8例手术探查 ,在硬膜外麻醉下清除阴囊血肿 ,均找到睾丸白膜的破裂… 相似文献
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睾丸损伤临床较常见 ,其包括单纯睾丸挫伤水肿、挫裂伤出血、睾丸破裂及鞘膜积血 ,另外还有精索和附睾的损伤等。对泌尿科医师来说 ,区别以上病变是困难的[1 ] 。本文根据对 1 5例睾丸损伤患者CT扫描结果 ,总结睾丸损伤的CT征象 ,为临床医师准确评估其损伤程度、范围及处理和预后提供帮助。材料与方法 1 995年 3月~ 2 0 0 0年 6月对 1 5例睾丸损伤的患者进行CT扫描 ,年龄 8~ 54岁 ,平均 30岁。患者于伤后 2~1 7h作CT检查。受伤者均无阴囊疾患既往史 ,砸伤 3例 ,踢伤 7例、挤压伤 2例、骑跨伤 3例。双侧睾丸损伤 1例、右侧 2例… 相似文献
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高频多谱勒超声对阴囊病变的临床应用 总被引:1,自引:0,他引:1
目的:探讨阴囊病变的超声图像特征及对阴囊病变的临床应用价值。方法:应用高频探头对30例阴囊病变进行检查及诊断,睾丸肿瘤及睾丸破裂伤等经手术病理证实。结果:30例阴囊病变中,睾丸或精索鞘膜积液10例、隐睾2例、外伤2例、肿瘤2例、附睾炎8例、附睾肿瘤4例、腹股沟斜疝2例。结论:高频多谱勒超声检查对阴囊病变的诊断及鉴别诊断有极高的临床应用价值。 相似文献
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Eighty patients with blunt scrotal trauma underwent real-time sonography with high-frequency transducers. Sonography showed testicular rupture in 14 patients, testicular hematoma in 8 patients, lesions of the epididymis in 17 cases, and hematocele without an associated lesion of the testicle or the epididymis in 28 patients; 13 examinations were normal. The diagnosis was confirmed at operation in 18 cases and by clinical and sonographical follow-up in 62 cases. Sonography was able not only to distinguish reliably testicular rupture from uncomplicated testicular hematoma (accuracy rate 100%). Characteristic findings in testicular rupture included inhomogeneity of the parenchymal pattern, contour abnormalities, poorly defined margins, and obvious disruption of the echogenic tunica albuginea or fragmentation of the testicle.
Correspondence to: W. Buchberger 相似文献
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Richard M. Schaffer M.D. 《Urologic radiology》1985,7(1):245-249
Ultrasound has emerged as the diagnostic imaging modality of choice in the evaluation of patients with scrotal trauma. Most studies of testicular rupture show great accuracy with virtually no instances of false-positive or false-negative diagnoses. Ultrasonography is capable of differentiating between scrotal hematoma, extratesticular fluid collections, posttraumatic torsion testis, posttraumatic epididymitis, epididymal hematoma, as well as testicular rupture. The differentiation of hematocele from pyocele or exudative hydrocele is generally not possible. In patients with suspected testicular rupture, an accurate diagnosis followed by prompt surgical repair is the key to preservation of testicular function. Ultrasound is an extremely useful adjunct to the physical examination in cases of blunt scrotal trauma both for the differential diagnosis of the enlarged scrotum and for determining the necessity for emergency surgery. 相似文献
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Ultrasonography of scrotal trauma 总被引:1,自引:0,他引:1
R M Schaffer 《Urologic radiology》1985,7(4):245-249
Ultrasound has emerged as the diagnostic imaging modality of choice in the evaluation of patients with scrotal trauma. Most studies of testicular rupture show great accuracy with virtually no instances of false-positive or false-negative diagnoses. Ultrasonography is capable of differentiating between scrotal hematoma, extratesticular fluid collections, posttraumatic torsion testis, posttraumatic epididymitis, epididymal hematoma, as well as testicular rupture. The differentiation of hematocele from pyocele or exudative hydrocele is generally not possible. In patients with suspected testicular rupture, an accurate diagnosis followed by prompt surgical repair is the key to preservation of testicular function. Ultrasound is an extremely useful adjunct to the physical examination in cases of blunt scrotal trauma both for the differential diagnosis of the enlarged scrotum and for determining the necessity for emergency surgery. 相似文献
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Dhara Rana Sayali Kulkarni Jamshed Zuberi Benjamin Rebein Fred Berlin 《Radiology Case Reports》2022,17(5):1692
Testicular or scrotal trauma is a rare form of trauma in the United States. Blunt trauma to the testicle can lead to testicular tunica albuginea rupture, testicle contusion, testicle hematoma, testicle torsion and epididymal injury. We report a case of a 48-year-old male patient who presented with right sided scrotal swelling and pain from a motorcycle collision. This turned out to be from a testicular rupture and resulting in a hematoma. The patient''s active bleeding from the right testicular artery was controlled by arterial embolization. Most reported cases of testicular artery bleeds are due to iatrogenic hemorrhage or non-traumatic injuries. Here, we report a rare case of testicular artery bleed due to a blunt trauma from a motorcycle collision. In conclusion, the testicular artery bleed was controlled successfully via testicular arterial embolization, making it a potential option for non-operative management for stable hemorrhage of the testicular artery. 相似文献
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Imaging of the acute scrotum 总被引:8,自引:0,他引:8
The scrotum is a superficial structure and clinical examination is frequently not enough for making a specific diagnosis.
In acute scrotal pain US can confirm the presumptive clinical diagnosis and provide additional relevant information. In testicular
torsion, color-Doppler imaging has a central role since it has become possible to identify it at early stage by showing absence
of perfusion in the affected testis before any gray-scale abnormality. Scintigraphy remains a satisfactory alternative in
evaluating testicular torsion and should be used when color Doppler is inadequate, raising doubts about the suspected torsion.
Diagnosis of torsion of testicular appendages is particularly difficult. Ischemic infarction shows a characteristic pattern
at gray-scale and color-Doppler imaging, whereas hemorrhagic ischemia may require MRI. Inflammatory diseases of the scrotum
can be easily investigated by echo color Doppler and conventional radiography, and CT can be particularly useful in the detection
of gas bubbles. In scrotal trauma, scrotal hematoma, hematocele, intratesticular hematoma, and testicular rupture can be identified
using gray-scale US with very good reliability. Magnetic resonance imaging is indicated when a small tear of tunica albuginea
is suspected but not visualized on US.
Received: 3 May 2000/Accepted: 8 June 2000 相似文献
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INTRODUCTION AND OBJECTIVES: Our experience concerning the use of color Doppler sonography (CDS) in the differential diagnosis of acute scrotum is reported. MATERIAL AND METHODS: From July 2000 to July 2005, 155 patients (median 17.2 years) were admitted with a diagnosis of acute scrotum (unilateral in 150 cases, bilateral in 5). Along with a careful anamnesis and the physical exam, all patients underwent a CDS study of the scrotal content using a sonograph GE Logiq 500 with a multifrequency (7.5-10 MHz) linear probe Small Part. The following CDS parameters were evaluated: intensity of the color-power signal on the testicular parenchyma and on the epididymis; systolic peak velocity (SPV) and telediastolic velocity (TDV) in correspondence of the gonadal hilum. Ultrasound and flowmetry parameters registered on the painful testis were compared with those registered on the healthy controlateral testis. The reduction/absence versus the increase of color-power signal in the parenchyma and the reduction/absence versus the increase of SPV and TDV in the centripetal intratesticular arteries were considered presumptive of testicular torsion versus orchiepididymitis. RESULTS: The results only refer to the 150 patients (300 testis) with acute monolateral scrotum. The clinical picture and the physical exam suggested a torsion of the spermatic cord in 40 cases, a spontaneous de-torsion in 5, an orchiepididymitis in 80, a blunt scrotal trauma in 15, a bulky epididymal cyst or a hydrocele in 4 and a testicular pain of unknown etiology in the remaining 6 cases. Standard US was pathological in 95 patients (63.3%); CDS was pathologic in 70 patients and in 42 of them suggested a testicular torsion. Fifty-three patients underwent surgical exploration: among 42 patients with a presumptive diagnosis of testicular torsion, the diagnosis was confirmed in 22 cases, no anomaly was found in 16 cases and in 4 patients a torsion of testicular appendix was found. The rupture of the tunica albuginea was present in six out of seven patients submitted to surgical exploration for previous blunt trauma and the sonographic diagnosis of hematocele was documented in all cases. The single false-negative diagnosis of testicular torsion in CDS occurred in an 18-month-old child. In presence of funicular torsion, the sensitivity and specificity of physical exam and CDS were 100% versus 95.7% and 86.5% versus 85.3%, respectively; sensitivity and specificity of SPV, TDV and color-Doppler signal on the testis were 100% and 94.8% versus 100% and 90.1% versus 95.7% and 90.8%. In the pre-operative assessment of scrotal trauma, the B-mode US showed a sensitivity and specificity of 100% and 90%, respectively; the color Doppler analysis has not supplied with additional elements for planning a surgical exploration. In presence of orchiepididymitis, the sensitivity and specificity of the physical exam in association to CDS was equal to 100%. In all patients with torsion of the testicular appendix, physical exam and CDS parameters were within normal limits. DISCUSSION AND CONCLUSIONS: In our experience CDS is an indispensable imaging modality for the clinical assessment of patients with acute scrotum; however, the informations it can afford are operator-dependent and have to be supported by the history and physical exam of the patient. CDS findings constitute probably an important medico-legal support when the necessity of surgical exploration is excluded; anyway, in presence of a clinical suspicion of testicular torsion, even with an apparently normal CDS, the surgical exploration is recommended. 相似文献
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Scrotal trauma is often mentioned as a cause of testicular atrophy yet there have been few studies documenting the effect of scrotal trauma on testicular size months or years following injury. We performed clinical and sonographic examinations in 10 patients who had suffered blunt scrotal trauma. A significant reduction in volume of the injured testis was observed in 5/10 cases at follow-up sonography. In two cases the affected testis was heterogeneous and colour flow Doppler examination showed reduced flow. In three cases the testis was homogeneous but reduced in volume and in the remaining five cases the affected testis appeared normal. We conclude that testicular atrophy is a sequel of scrotal trauma and occurred in 50% of patients in this study. 相似文献