MRI对阴囊闭合性损伤的诊断价值

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。     

急性闭合性睾丸损伤临床CT诊断

目的　探讨急性闭合性睾丸损伤临床CT诊断价值。方法　对 12例急性闭合性睾丸损伤临床及CT平扫检查进行分析。结果　睾丸轻度损伤肿大 1例 ,鞘膜下积血 1例 ,睾丸实质出血及白膜下血肿 2例。CT检查正确诊断睾丸碎裂 8例 ,正常结构消失 ,白膜中断 ,睾丸组织突出 ,睾丸碎片分离征象。结论　CT检查能准确诊断各种类型睾丸损伤 ,并能确定损伤的程度 ,为临床尽早提供可靠的诊断依据。     

急性阴囊闭合性损伤的磁共振成像与彩色多普勒超声诊断

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。     

闭合性阴囊损伤的CT诊断

目的确定闭合性阴囊损伤的ＣＴ诊断价值。方法 对２３例闭合性阴囊损伤的ＣＴ资料及临床处理进行回顾性分析。结果 根据睾丸失去正常的卵圆形结构，白膜中断，睾丸组织突出或睾丸断片分离等征象，ＣＴ正确诊断睾丸破裂８例；ＣＴ亦能显示阴囊壁血肿，鞘膜积血，白膜下血肿，睾丸实质血肿，睾丸附睾挫伤，精索及附睾血肿等其他病理改变。１７例手术探查证实ＣＴ显示的各种病理改变与手术病理完全相符。结论 ＣＴ能准确诊断各种类型     

急性阴囊疾病的彩色多普勒超声诊断

目的探讨彩色多普勒超声对急性阴囊病变的诊断与鉴别诊断价值。方法对急性睾丸炎、急性附睾炎、睾丸损伤、睾丸扭转及附件扭转52例急性阴囊疾病的彩色多普勒超声图像进行对比分析。结果本组急性阴囊疾病的超声检查结果与临床最后诊断及手术结果完全一致。本组52例中，急性睾丸炎10例，急性附睾炎16例，睾丸损伤12例，睾丸扭转9例以及睾丸附件扭转5例。结论彩色多普勒超声可作为诊断与鉴别诊断急性阴囊疾病的首选的无创临床检查手段。     

51例阴囊及其内容物损伤的超声检查分析

阴囊及其内容物损伤临床上并不少见 ,常因得不到早期诊断和治疗导致睾丸切除。我院近 10年共收治 5 1例闭合性阴囊及其内容物损伤患者 ,诊断过程中均采用超声检查。现就超声检查在此类伤情中的诊断价值探讨如下。临　床　资　料一、一般资料与临床表现本组 5 1例 ;年龄 16～ 6 7岁 ,平均32 .2岁。左侧 2 8例 ,右侧 19例 ,双侧 4例。致伤原因 :踢伤 37例 ,钝物撞伤 5例 ,交通伤 9例。受伤时间 1ｈ～ 9ｄ ,平均 9.2ｈ。主要表现为阴囊瘀血肿胀、睾丸肿大 ,其中 18例睾丸轮廓不规则 ,临床诊断为睾丸破裂 ,5例睾丸轮廓清楚诊断为睾丸挫伤 ,5例患…     

训练致闭合性睾丸挫裂伤11例分析探讨

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…     

睾丸损伤的CT诊断与分型

目的 探讨CT检查对睾丸损伤的诊断与分型以及对临床的价值.方法 对26例睾丸损伤的临床及CT表现进行回顾性分析.结果 根据CT表现将睾丸损伤分为5型:白膜下血肿型3例;肿胀型4例;出血型12例,其中局限性出血2例,广泛性出血10例;破裂型6例;脱位型1例.睾丸损伤的CT诊断与临床符合率为100%,而睾丸损伤的CT分型与术后诊断符合率为94.2%.结论 CT能明确作出睾丸损伤的诊断与分型,为临床选择治疗方案提供可靠依据.     

急性闭合性胰腺损伤临床CT诊断

目的：探讨急性闭合性胰腺损伤临床CT诊断价值。方法：对21例急性闭合性胰腺损伤CT平扫检查结果分析。结果：胰腺表现为体积增大者5例；胰腺周围脂肪层增厚，模糊并有左侧肾前筋膜增厚者10例；胰头、颈、体区见垂直于长轴的条形低密度影，胰腺密度不均，并有胰周，胰系膜上动脉周围，横结肠周围，脾肾周围间隙内积液者6例。结论：CT能及时准确地检查出胰腺的损伤，确定损伤程度，为临床提供可靠的诊断依据。     

CT平扫对肠及肠系膜损伤诊断价值探讨

目的探讨CT平扫在肠及肠系膜损伤诊断中的实际应用价值。方法回顾分析经手术或临床证实的53例腹部闭合性损伤中肠及肠系膜损伤病例的临床资料及CT平扫表现。结果 CT平扫主要定性诊断征象包括:腹腔积气17例;腹膜后积气1例;腹腔积液积血39例;肠壁增厚31例;肠系膜渗出及血肿17例;肠管扩张4例。37例CT平扫提示损伤部位,其中21例与手术或临床最终诊断结果一致。结论 CT平扫能对腹部闭合性损伤中肠及肠系膜损伤作出准确诊断。     

急诊阴囊疼痛患者核素阴囊显像的临床研究

目的 评价放射性核素阴囊显像用于鉴别急性睾丸蒂扭转和急性睾丸附睾炎的临床应用价值。方法 对４９例主诉急性阴囊疼痛患者的核素阴囊显像结果进行临床分析,并与超声检查结果相比较。“弹丸”式静脉注射Ｎａ＾９９Ｔｃ＾ｍＯ４后,分别行动态和静态采集,得到睾丸血流灌注像和静态血池像。结果 阴囊显像患侧阴囊放射性分布呈扭转表现的３７例患者中,经临床手术证实为睾丸蒂扭转者３５例,余２例为患侧腹股沟斜疝;３５例确诊为     

Sonography of the pediatric scrotum: emphasis on the Ts--torsion, trauma, and tumors

OBJECTIVE: The purpose of this article is to review the different scrotal disease entities in the pediatric population, focusing on acute scrotum, traumatic injuries, and testicular tumors. CONCLUSION: Many pediatric scrotal disorders can be well characterized on sonography. An understanding of the various disease entities, their clinical presentations, and the typical sonographic features should all be combined to make an accurate diagnosis.     

创伤性湿肺的X线、CT诊断

目的 :总结X线、CT胸部检查对创伤性湿肺的诊断价值。材料和方法 :分析临床证实的创伤性湿肺 2 6例 ,全部病例行胸部X线及CT检查。结果 :创伤性湿肺多出现伤侧或双侧中下肺野 ,表现为间质型 10例 ,节段实变型 4例 ,弥漫实变型 3例 ,云雾型 9例。对病变的显示CT明显优于X线检查。结论 :对临床疑为创伤性湿肺患者建议首选胸部CT检查 ,对确诊的患者行胸部X线监测     

Clinical study of scrotum scintigraphy in 49 patients with acute scrotal pain: A comparison with ultrasonography

The significance of scrotum scintigraphy in differentiating acute testicular torsion from acute orchiepididymitis was evaluated. In this report, 49 patients with acute scrotal pain were examined with radionuclide scrotum scintigraphy and ultrasonography in parallel for comparison. Of 37 patients with decreased radioactivity in the abnormal side scrotum, 35 were diagnosed with testicular torsion surgically and the other 2 were diagnosed with indirect inguinal hernia. Only 17 among the 35 patients were diagnosed by ultrasonography as having testicular torsion. The remaining 12 patients with increased radioactivity in the abnormal side of the scrotum were all diagnosed with orchiepididymitis through conservative treatment and clinical follow-up, but only 8 of the 12 were correctly and exactly diagnosed by ultrasonography. In the process of diagnosing acute scrotal pain, radionuclide scrotum scintigraphy has obvious advantage over ultrasonography. It also has the advantage of being simple, fast and accurate but without any detrimental effect on the human body.     

Application of spiral computerized tomography in the study of traumatic lesions of the thoracic aorta

PURPOSE: Acute thoracic aortic injuries account for up to 10-20% of fatalities in high-speed deceleration road accidents and have an estimated immediate fatality rate of 80-90%. Untreated survivors to acute trauma (10-20%) have a dismal prognosis: 30% of them die within 6 hours, 40-50% die within 24 hours, and 90% within 4 months. We investigated the diagnostic accuracy of Helical Computed Tomography (Helical CT) in acute traumatic injuries of the thoracic aorta, and the role of this technique in the diagnostic management of trauma patients with a strong suspicion of aortic rupture. MATERIAL AND METHODS: We compared retrospectively the chest Helical CT findings of 256 trauma patients examined June 1995 through August 1999. All patients underwent a plain chest radiograph in supine recumbency when admitted to the Emergency Room. Chest Helical CT examinations were performed according to trauma score, to associated traumatic lesions and to plain chest radiographic findings. All the examinations were performed with no intravenous contrast agent administration and the pitch 2 technique. After a previous baseline study, contrast-enhanced scans were acquired with pitch 1 in 87 patients. All examinations were assessed for the presence of mediastinal hematoma, periaortic hematoma, traumatic pseudodiverticulum, irregular aortic wall or contour and intimal flap as signs of aortic rupture. RESULTS: Helical CT showed thoracic aortic lesions in 9 of 256 patients examined. In all the 9 cases we found a mediastinal hematoma and all of them had positive plain chest radiographic findings of mediastinal enlargement. Moreover, in 6 cases aortic knob blurring was also evident on plain chest film and in 5 cases depressed left mainstem bronchus and trachea deviation rightwards were observed. All aortic lesions were identified on axial scans and located at the isthmus of level. Aortic rupture was always depicted as pseudodiverticulum of the proximal descending tract and intimal flap. We also found periaortic hematoma in 6 cases and intramural hematoma in 1 case. There were no false positive results in our series: 7 patients with Helical CT diagnosis of aortic rupture were submitted to conventional aortography that confirmed both type and extension of the lesions as detected by Helical CT, and all findings were confirmed by gross inspection at surgery. No false negative results have been recorded so far: untreated aortic ruptures are fatal within 4 months in 90% of patients, or they may evolve into chronic pseudoaneurysm in about 5% of survivors. CONCLUSIONS: In our experience Helical CT had much higher diagnostic sensitivity and specificity than plain chest radiography. In agreement with larger published series, in our small one the diagnostic accuracy of Helical CT was 100% in the evaluation of traumatic aortic ruptures. Moreover, Helical CT is faster and less invasive than conventional aortography, which makes this diagnostic modality increasingly used and markedly improves the management of the serious trauma patient. The more widespread use of this diagnostic tool has permitted to standardize the technique and now Helical CT can be used not only as a screening modality for patients that undergo digital aortography, but also as a reliable diagnostic method for surgical planning.     

Epididymoorchitis mimicking testicular torsion in Henoch-Schönlein purpura

Henoch-Sch?nlein purpura, although being a systemic vasculitis, mostly involves skin, gastrointestinal system, joints, and kidneys. Testicular involvement is a rare occurrence. A 7-year-old boy with Henoch-Sch?nlein purpura developed acute scrotum and was referred to rule out testicular torsion. On gray-scale ultrasonography, the testes and epididymis were slightly enlarged, and had heterogeneous and hypoechoic echotexture. The scrotal wall was thickened as well. Color and power Doppler ultrasonography revealed increased vascularity in scrotal contents. Testicular torsion was excluded and the diagnosis of testicular involvement of Henoch-Sch?nlein purpura was established. Color Doppler US, together with gray-scale findings, can be useful in the evaluation of Henoch-Sch?nlein purpura with acute scrotum, excluding testicular torsion and preventing unnecessary surgery.     

外伤性脾破裂的螺旋CT诊断（附36例分析）

目的评价螺旋CT在外伤性脾破裂诊断中的价值。方法收集我院2001年5月至2008年10月36例明确诊断为脾破裂的CT资料进行分析。结果CT平扫发现脾破裂20例,脾包膜下破裂出血10例,3例CT平扫阴性经作增强扫描证实,3例为迟缓性出血。结论CT扫描有利于对外伤性脾破裂的及时诊断,有利于指导临床治疗。     

双螺旋CT增强扫描对外伤性肾损伤的诊断价值

目的:探讨CT增强扫描在对伤性肾损伤诊断中的应用价值。材料和方法:回顾性分析28例肾损伤的CT平扫及增强扫描表现。结果:28例中,平扫能确诊肾损伤20例、可疑肾损伤5例、未见异常3例,敏感性89.2%、特异性71.4%;CT增强扫描后,全部确诊为肾损伤,敏感性100%、特异性100%。结论:CT增强扫描在外伤性肾损伤的诊断中具有重要的作用,能明显提高诊断准确率。