彩色多普勒超声诊断急性附睾、睾丸炎的价值

目的探讨彩色多普勒血流显像对急性附睾、睾丸炎的诊断价值。方法正常组与病变组对比观察二维声像图表现、血流信号的多少、血流速度、RI、S／D比值，并进行统计学处理。结果病变组急性睾丸炎15例，急性附睾炎63例与正常组30例比较有较特征性的声像图表现，各项测值有显著的差异。结论彩色多普勒超声诊断急性附睾、睾丸炎具有较可靠的临床价值。     

彩色多普勒高频超声在诊断急性附睾炎中的应用

急性附睾炎是阴囊内常见的一种炎症,起病急,局部疼痛明显,临床症状与急性睾丸炎、急性精索炎、急性精索附睾炎甚至睾丸扭转相似。彩色多普勒高频超声对于位置浅表的附睾显示良好,对急性附睾炎的诊断具有重要的价值。现就我院31例临床确诊为急性附睾炎的彩色多普勒超声声像图特征进行回顾性分析,报告如下。     

附睾炎的超声诊断

目的总结附睾炎高频彩色多普勒超声图像特征及超声对附睾炎的诊断价值。方法对55例经高频彩色多普勒超声检查并经手术、病理确诊的附睾炎患者的声像图资料进行回顾性分析。结果55例附睾炎中,慢性附睾炎36例、附睾精子肉芽肿性炎9例、急性附睾炎7例及附睾结核3例。其中2例附睾精子肉芽肿性炎和1例急性附睾炎误诊为附睾肿瘤。结论高频彩色多普勒超声结合临床资料综合分析,能准确诊断附睾炎。     

高频超声、彩色血流图及能量图在阴囊急症诊断中的临床价值

目的 探讨应用高频超声、彩色血流图及能量图在阴囊急症诊断中的临床价值。方法 选择连续观察、追踪随访临床确诊的阴囊急症87例。其中阴囊外伤13例，急性睾丸扭转12例，急性附睾炎32例，急性睾丸炎7例，急性睾丸一附睾炎15例，急性睾丸附件扭转8例。用高频二维超声观察左、右睾丸、附睾的形态大小及内部回声等；用彩色血流图及能量图观察血供信息。结果 以睾丸一附睾内无血供诊断睾丸扭转，敏感性、特异性和准确性均为100％。以睾丸或／和附睾肿大及高血供诊断急性睾丸或／和附睾炎，敏感性94．4％、特异性97％和准确性95．4％。结论 高频超声、彩色血流图及能量图在阴囊急症诊断中有重要的临床价值，尤其是在鉴别急性睾丸扭转、急性睾丸附件扭转和急性睾丸或／和附睾炎方面有快速、准确的意义。     

附睾炎的彩色多普勒超声图像分析

目的 分析58例附睾炎二维及彩色血流图，探讨其对附睾炎的诊断价值。方法 用直接法扫查睾丸及附睾，显示二维及彩色血流声像。结果 36例急性附睾炎和22例慢性附睾炎均有较特异的二维及彩色血流声像。结论 彩超在急慢性附睾炎的临床诊断及疗效判断有重要价值。     

超声多普勒检查在阴囊急症中的应用

目的 探讨阴囊急症的彩色多普勒血流显像（CDFI）和彩色多普勒能量图（CDE）特征及其鉴别诊断。方法 用CDFI和CDE观察64例阴囊急症病灶区血供状况,并与健侧比较。对37例急性附睾炎及睾丸炎的附睾动脉和3例早期睾丸扭转的睾丸内动脉的血流参数进行检测,并与30例正常人对照。结果 45例急性附睾炎及睾丸炎中37例表现为高血供,附睾内血流速度明显高于正常对照组,阻力指数低于正常对照组（P〈0．01）;5例病变侧睾丸无血供或低血供,睾丸内血流阻力指数增高,超声诊断睾丸扭转,与手术病理诊断相符;3例睾丸附件扭转,附件内无血流信号显示,而附着处组织血供增多;11例阴囊外伤中,睾丸完全破裂1例,部分破裂2例,挫伤5例,单纯血肿3例。结论 CDFI和CDE可准确地鉴别睾丸扭转、睾丸附件扭转和炎症,有助于睾丸损伤的临床治疗方案的选择,可作为阴囊急症诊断的首选检查方法。     

彩色多普勒超声对附睾炎症性肿块的诊断价值

目的：探讨彩色多普勒超声对特异性和非特异性感染的附睾炎症性肿块的诊断价值。方法：对超声诊断的6例附睾结核和43例急性、慢性附睾炎引起的肿块，进行随访和回顾性分析。结果：超声诊断符合率95．9％（47／49），误诊率4．1％（2／49）。结论：超声显像对附睾炎症性肿块的诊断有较高的临床应用价值，但用彩色多普勒超声检测血流情况来鉴别特异性和非特异性感染，尚需进一步研究探讨。     

彩色多普勒超声对睾丸扭转与急性附睾-睾丸炎的鉴别诊断

目的 :探讨彩色多普勒超声对睾丸扭转与急性附睾 -睾丸炎鉴别诊断中的价值。方法 :首先用二维超声显示 14例睾丸扭转与急性附睾 -睾丸炎的睾丸、附睾的位置、大小、形态、回声 ,继之用彩色多普勒(CDFI)观察睾丸、附睾内的血供情况 ,其诊断均经手术或临床证实。结果 :4例睾丸扭转患侧睾丸、附睾内血供减少或消失 ,10例急性附睾 -睾丸炎血供增多。 1例超声检查过程中自行复位后的血供增多 ,易误诊为急性附睾 -睾丸炎。结论 :CDFI作为一种经济、实用、准确、无创性的检查手段 ,是目前鉴别睾丸扭转与急性附睾炎的首选方法。     

高频彩色多普勒超声在睾丸附睾急症诊断中的应用

目的探讨高频彩色多普勒技术诊断睾丸附睾急症的价值。方法回顾分析111例睾丸附睾急症患者的声像图资料。结果 111例中,急性附睾炎68例,急性睾丸附睾炎8例,睾丸扭转16例,睾丸附件扭转3例,睾丸血肿10例,睾丸破裂6例。结论高频彩色多普勒超声在诊断睾丸附睾急症方面有很高的临床价值。     

52例附睾炎的高频彩色多普勒超声诊断分析

目的探讨彩色多普勒超声对附睾炎的诊断价值。方法回顾52例附睾炎病例的临床资料,总结分析CDFI声像图特征及鉴别诊断。结果52例中急性附睾炎38例(73.0%),慢性附睾炎14例(26.9%);慢性附睾炎误诊为附睾肿瘤2例。结论高频彩超对附睾炎的诊断符合率为91.65%,可为临床诊断及治疗提供可靠的信息,是诊断附睾炎的有效方法之一。     

阴囊急性炎症的彩色多普勒超声表现及其评价

目的进一步探讨阴囊急性炎症的彩色多普勒超声（ＣＤＵ）表现并评价其临床应用价值。方法应用ＣＤＵ对５２例阴囊急性炎症进行检查,观察阴囊内容物的形态、回声及血流变化,并通过手术及临床治疗随访证实诊断。结果ＣＤＵ诊断符合率为９８％,其中睾丸炎为９１％（１０／１１）,炎症并肿瘤６７％（２／３）,附睾炎（２１）、睾丸附睾炎（９）、精索炎症（４）和阴囊壁感染（５）均正确诊断。结论本文资料表明,ＣＤＵ能够诊断急性睾丸附睾炎,了解急性炎症的预后,并对其疗效作出评价;还可帮助鉴别急性睾丸炎或是睾丸扭转、局灶性炎症或是肿瘤。     

Color Doppler sonography in acute epididymitis and orchitis

Clinical diagnosis of patients with acute scrotal pain is frequently imperfect. Imaging, using nuclear medicine scintigraphy and hand-held continuous-wave Doppler ultrasound devices, has been used in these patients. We retrospectively analyzed 28 consecutive patients referred for scrotal sonography, all of whom had been imaged using color Doppler sonography. Of 22 patients with confirmed diagnoses, 11 had acute epididymitis/orchitis and 11 had another diagnosis. Ten of 11 patients with acute epididymitis/orchitis had increased epididymal flow. Eight also had increased testicular flow. None of the 11 patients without acute epididymitis/orchitis had increased flow. Our data suggest that color Doppler sonography may be useful in establishing the diagnosis of acute epididymitis/orchitis. This might decrease the need for scrotal exploration. No distinction could be made among scrotal lesions in the nonacute epididymitis/orchitis group. Sensitivity was inadequate to reliably detect flow in normal testicles, a prerequisite to accurately diagnose torsion. Newly improved sensitivity may enhance the utility of color Doppler sonography in assessing patients with acute scrotal pathology.     

Gray-scale and power doppler sonographic appearances of acute inflammatory diseases of the scrotum

PURPOSE: We describe the spectrum of gray-scale and power Doppler sonographic appearances in inflammatory scrotal diseases. METHODS: Twenty-five patients ranging in age from 3 to 69 years underwent gray-scale and power Doppler sonography with multifrequency transducers of 7-9 MHz or 10-13 MHz. In addition, color Doppler and power Doppler findings were compared in 7 cases. RESULTS: In all 5 prepubertal patients, power Doppler imaging demonstrated hyperemia associated with epididymitis and, in some cases, orchitis. Among the 20 pubertal and adult patients, power Doppler imaging revealed increased vascularity associated with spermatic cord involvement, epididymitis, orchiepididymitis, or orchitis. Enlargement and heterogeneity of the epididymis and/or testis were seen in 11 patients, with vas efferens ectasia in 3 patients. Abscess formation and testicular infarction were easily depicted by power Doppler imaging. In 5 cases total, hyperemia was the only sonographic finding of inflammation. In the comparison between color and power Doppler imaging, a subjective increase in the number and length of vessels was seen with power Doppler imaging. CONCLUSIONS: Power Doppler imaging is an easy and fast Doppler modality for evaluating inflammatory conditions of the scrotum and proved especially useful in cases with no gray-scale sonographic anomalies, in prepubertal patients, and in patients with abscesses or ischemic lesions.     

彩色多普勒超声在附睾结核治疗中的应用价值

目的探讨附睾结核的彩色多普勒超声分型及其在治疗中的价值。方法对33例附睾结核患者的彩色多普勒超声表现及手术所见进行对比分析。结果对33例附睾结核患者超声正确诊断29例，诊断符合率为87．9％。3例附睾呈弥漫性病变，血供丰富；13例附睾内见结节病灶，其中3例结节内有液性无回声区，3例内有点状高回声区，7例呈低回声；17例阴囊内多发病灶，其中11例附睾表现为弥漫肿大、回声不均、血供增多。附睾结核依发生部位可将超声表现分为弥漫型、结节型、复杂型，其中结节型依回声及病理表现又分为脓性结节、钙化结节和干酪结节。结论弥漫型附睾结核容易累及睾丸，应早期手术；脓性结节以手术治疗为主；钙化结节无需手术；干酪结节先药物治疗，如效果不佳应手术治疗；复杂型必须手术治疗。超声首诊怀疑附睾结核时，系统扫查泌尿系有助于发现无症状的泌尿系结核。     

附睾炎及精索炎的彩色多普勒诊断价值

目的 探讨彩色多普勒超声在急、慢性附睾炎及精索炎诊断中的临床价值。方法 采用ATL超9、Sequoia 512、Aloka SSD-3500彩色超声诊断仪，探头频率5～10MHz，对病患部位进行观察。结果 附睾炎及精索炎急性期在二维图像上表现为不同程度的低回声水肿、体积增大，彩色多普勒显示血供丰富等血流动力学改变，治疗后血流明显减少。慢性期二维图像表现为病患部位回声增粗、不均匀，周边毛糙、不平，彩色多普勒显示血供减少，血流速度低于正常。结论 由于超声图像直观，解剖特征强，方便易行，应用于附睾及精索检查时，根据组织形态及血流信号的改变，可作为诊断与疗效评定的重要指标。     

Chronic tuberculous epididymitis: color Doppler US findings with histopathologic correlation

BACKGROUND: The aim of this study was to determine the color Doppler features of tuberculous epididymitis and to correlate these findings with histopathologic findings. METHODS: Color Doppler ultrasound (US) findings of 12 histopathologically proven tuberculous epididymitis and tuberculous epididymo-orchitis in 11 consecutive patients were retrospectively analyzed. Color Doppler US findings of tuberculous epididymitis were correlated with histopathologic findings. RESULTS: Color Doppler US findings of tuberculous epididymitis demonstrated no blood flow in the epididymal lesions except for focal linear or spotty flow signals in the peripheral portion. These findings correlated well with pathologic findings; the central portion of the epididymal lesions demonstrated granulomas with caseation necrosis, and the peripheral portion of the epididymal lesions had several medium to small vessels. CONCLUSIONS: Color Doppler US may be helpful for differential diagnosis of tuberculous epididymitis and non-tuberculous epididymitis.     

彩色多普勒超声诊断睾丸附件扭转的价值

目的探讨彩色多普勒超声诊断睾丸附件扭转的价值。方法对37例经彩色多普勒超声检查并经临床确诊为睾丸附件扭转患者的超声声像图表现进行回顾性分析。结果37例患者中,超声诊断为睾丸附件扭转者35例,超声误诊2例,诊断准确率为94.6%（35/37）。彩色多普勒超声显示睾丸上极或附睾头旁大小不等的不均质高回声结节,内无血流;25例患侧睾丸呈不同程度增大,血流增多;29例显示睾丸鞘膜腔内积液;30例显示阴囊壁不同程度增厚。结论睾丸上极或附睾头旁无血流的高回声结节是睾丸附件扭转的特征性声像图表现。彩色多普勒超声对睾丸附件扭转诊断准确性高,可作为诊断睾丸附件扭转的最佳检查方法。