精索扭转的彩色多普勒超声诊断

为研究精索扭转的彩色多普勒超声（ＣＤＵ）表现及其诊断价值，采用彩色多普勒电脑声像仪对１３例精索扭转、１７例急性睾丸附睾炎及７２例正常睾丸进行检查。异常３０例中，１０例进行手术治疗，其余病例经随访得到诊断结果。ＣＤＵ诊断精索扭转敏感性为９２．３％，特异性为１００％。研究表明，ＣＤＵ能够发现精索扭转并评价其程度，可帮助临床医师迅速准确地作出诊断     

彩色多普勒超声诊断精索病变的价值

目的探讨彩色多普勒超声在精索病变诊断与鉴别诊断中的价值。方法分别在阴囊、阴囊根部及腹股沟部进行超声扫查,观察精索径线的大小、声像图表现及血流情况。结果精索静脉曲张35例、精索炎36例、精索鞘膜积液25例及精索肿瘤3例,各有其声像图特征表现。结论彩色多普勒超声对于精索疾病的诊断与鉴别诊断,具有重要的临床价值。     

睾丸精索扭转的诊断与治疗（附18例报告）

目的：总结睾丸精索扭转的诊断及治疗方法。方法：回顾分析18例睾丸精索扭转患者的临床资料。患者年龄1～49岁,平均20.5岁,其中小于25岁者14例,占78%。左侧12例,占67%。发病至确诊时间5h-2周。结果：初诊误诊14例。18例均行手术治疗,5例扭转时间短,睾丸血运良好者手术后保留睾丸,13例因睾丸已坏死,行睾丸切除术。17例为鞘膜内扭转,1例为鞘膜外扭转。结论：彩色多普勒血流动态显象检查（CDFI）是急性精索扭转早期诊断可靠方法;手术探查是提高睾丸存活率的重要手段。     

Neuroblastoma with spermatic cord metastasis in a child: sonographic findings.

We report a case of neuroblastoma in a patient who had no involvement of the spermatic cord at diagnosis but who developed spermatic cord metastasis 2 months later. The metastasis appeared on sonography as a hypoechoic, highly vascular, fusiform, hard, 14x10x7 mm mass located in the right inguinal canal and extending into the scrotum. The diagnosis of spermatic cord metastasis was confirmed by resection and histopathologic examination. We recommend that the scrotum and spermatic cord be evaluated by high-resolution sonography in children with neuroblastoma, both at the time of diagnosis and during follow-up.     

Assessment of acute scrotum by Doppler color flow imaging: A report of four cases

We used an Aloka SSD-2000 ultrasound unit with a 5 MHz convex scanner to assess one case of torsion of the spermatic cord, one case of orchitis, and two cases of epididymitis. Color flow imaging showed absence of blood flow signals in the testis in the case of torsion of the spermatic cord, while blood flow signals in the scrotum were significantly increased in the cases of orchitis and epididymitis. Blood flow signals decreased after chemotherapy. Color flow imaging may thus prove useful in the diagnosis and follow-up of patients with acute scrotum.     

实时精索团块在超声诊断睾丸扭转中的价值

目的 探讨实时精索团块在超声诊断睾丸扭转中的价值。方法 经超声检查的睾丸扭转患者42例,分析其阴囊的二维及彩色多普勒超声表现,仔细研究精索的走行,寻找有无实时精索团块。结果 所有病例均经手术证实。37例为完全扭转,二维及彩色多普勒上均可见精索团块,精索团块及其远端无血流信号。5例为不完全扭转,二维及彩色多普勒上均可见精索团块,精索团块内血流减少。结论 实时精索团块是诊断睾丸完全、不完全扭转最敏感、最特异的超声表现。     

不同程度精索扭转的超声诊断与临床对照分析

【目的】提高超声检查在精索扭转的诊断价值。【方法】分析50例经临床手术证实的不同程度精索扭转患者彩色多普勒超声图像特征。【结果】150例精索扭转患者中,48例因扭转程度不同,出现不同的精索二维声像图改变,40例彩色多普勒显像出现睾丸内血流改变异常,20例出现睾丸内二维声像图改变,敏感性分别为96％、80％、40％,特异性分别为100％、100％、67％。【结论】不同程度的精索扭转可出现不同的彩色多普勒超声改变,超声可作为临床首选的无创检查手段。     

Experimental study of the sonographic diagnosis of testicular torsion.

The sonographic and Doppler features of acute spermatic cord torsion were investigated in eight dogs. Serial sonography following torsion demonstrated unambiguous abnormalities in all experimental subjects within one hour. The observed abnormalities included increase in size of the spermatic cord, testis, and epididymis, decrease in echogenicity of the testis and epididymis, and loss of Doppler signal from the cord. Sonographic abnormalities were clearly visible before any histologic change was detected and well in advance of the onset of cellular necrosis. Since every experimental subject had an abnormal testicle, the identification of a normal testicle in a clinical setting is felt to exclude torsion. Combined gray-scale sonographic and Doppler features appear promising in the diagnosis of acute spermatic cord torsion and its distinction from acute epididymo-orchitis.     

精索副神经节瘤1例病例报告并文献复习

目的：提高对精索副神经节瘤的诊断和治疗认识。方法：报告我院2009年2月收治1例精索副神经节瘤患者,并复习文献。患者,男,66岁,因发现右侧阴囊上部包块20年入院。查体发现双侧精索静脉曲张,右侧阴囊上部占位,B超提示双侧精索静脉曲张,右侧阴囊上部34mm×28mm不均质包块,血供丰富。结果：行双侧精索静脉高位结扎及右侧精索包块切除术。术中见包块程球形、质中等、边界清楚。术后病检：副神经节瘤。1周后行扩切,未发现有肿瘤浸润。术后随访2月至今无复发及转移。结论：精索副神经节瘤诊断依赖于病检,良恶性判别尚无统一标准,治疗经完整切除肿瘤且术后需长期随访。     

彩色多普勒超声在精索扭转诊断鉴别诊断中的应用研究进展

在泌尿外科中,精索扭转是导致急性阴囊胀痛常见致病因素,在临床中极易出现漏诊及误诊情况。在以往的评估诊断中大多采用常规超声辅助检查,但该项检测不能够对微小血管及低速血流进行准确显示,进而不利于病情准确判定。彩色多普勒超声属于一种新型的超声检查技术,本研究通过对精索扭转患者采用彩色多普勒超声诊断,进而对其应用价值展开综述。     

保留睾丸引带和精索双向血供治疗小儿低位隐睾67例

【目的】探讨保留睾丸引带和精索血管对小儿低位隐睾治疗的疗效。【方法】选取B超报告睾丸位置位于腹股沟中下段,专科检查在腹股沟区能扪及睾丸的隐睾患者125例,其中A组67例采用经腹股沟皮纹横切口,保留睾丸引带和精索血管双向血供,B组58例患儿采用传统的腹股沟大斜切口,单纯保留精索血管,术后随访6月至1年。【结果】两组比较,A组手术时间、手术切口长度、术后睾丸血供、睾丸硬度明显较B组良好（P〈0．05）;术后睾丸的位置、复发、性激素水平两组无明显差异（P〉0．05）。【结论】采用经腹股沟皮纹横切口保留睾丸引带和精索血管血供治疗小儿隐睾创伤小,术后睾丸血供良好,手术时间缩短,术后切口瘢痕不明显,外形美观,疗效满意。     

Lymphoma of the spermatic cord: Sonographic appearance

Primary lymphoma of the spermatic cord is a rare disease accounting for about 1.6% of primary spermatic cord tumors. We hereby present a new case in which color Doppler ultrasound (US), contrast‐enhanced US, and MRI suggested a specific diagnosis that was subsequently confirmed pathologically. Color Doppler US revealed mostly hypoechoic, slighly hypervascular tissue surrounding the normal spermatic vessels, which was markedly hypervascular at contrast‐enhanced US. MRI showed diffuse infiltration by homogeneously enhancing tissue surrounding the spermatic vessels hypointense to testis on T2‐weighted images, isointense on T1‐weighed images, lacking fat tissue, with relatively high signal intensity on diffusion‐weighted images. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 42 :509–512, 2014     

聚丙烯补片在腹股沟疝修补术中对输精管的影响

目的:探讨聚丙烯补片行腹股沟疝修补术对输精管的影响。方法:使用巴德公司生产SpomaTex补片进行疝修补,用来保护精索与输精管,并与同期单纯用聚丙烯平片行疝修补术的患者进行对比,观察二者对输精管的影响。结果:用SpomaTex补片与用普通补片行腹股沟疝修补的患者均未发现精索粘连及不育等并发症。结论:近期随访中,未发现精索粘连及不育等并发症,有待于长期各科合作的随访,国外已有聚丙烯补片引起不育的报道,应引起临床的高度重视。     

超声引导下注射聚桂醇硬化治疗精索鞘膜积液

目的探讨超声引导下注射聚桂醇硬化治疗精索鞘膜积液的治疗效果。 方法选择2012年5月至2014年12月鄂尔多斯市中心医院收治的超声诊断为精索鞘膜积液的患儿35例。超声引导下应用静脉留置针穿刺抽吸鞘膜积液,囊腔内注入聚桂醇注射液,保留5 min后全部抽出。1、3、6个月随访复查,评价疗效。一次治疗有效和无效的患儿给予再次治疗。仍无效者建议转手术治疗。治愈患儿继续随访精索有无增粗、变细、硬结等改变。 结果一次注射治愈31例（31/35,88.6%）,二次注射治愈3例（3/35,8.6%）。1例经二次治疗仍无效,转手术治疗。总治愈率97.1%（34/35）。治疗中患儿均无不适,治疗后随访腹股沟区未触及包块,与对侧精索对比,精索直径无增粗、变细等异常改变,精索周围无增厚膜状回声。 结论超声引导下注射聚桂醇硬化治疗精索鞘膜积液是一种高效的方法,可使绝大部分患儿避免手术治疗。     

睾丸扭转的诊治及误诊分析

目的提高睾丸扭转的诊断和治疗水平。方法对12例睾丸扭转的临床资料进行总结,平均年龄13．5岁,〈20岁占83．3％,左侧占75％。结果6例患者经B超及CDFI确诊为睾丸扭转,6例误诊。8例患侧睾丸切除。结论早期诊断,及时治疗是提高疗效的关键。CDFI应作为诊断该疾病的首选检查方法。及时手术探查是提高睾丸成活率的关键。     

彩色多普勒超声诊断婴幼儿睾丸微小结石的临床意义

目的探讨婴幼儿睾丸微小结石的彩色多普勒超声表现及意义。方法使用高频率彩色超声诊断仪检查11例7个月至3岁婴幼儿睾丸微小结石患者。观察双侧睾丸的大小、内部回声,了解睾丸及精索血流情况。结果婴幼儿睾丸微小结石超声表现睾丸实质内散在或密集分布强回声光点,最大1．5mm,最小约0．5mm,无声影,10例为双侧,1例为单侧。结论婴幼儿睾丸微小结石超声表现明显,诊断明确,超声具有重要的诊断价值。     

精索鞘膜腔积液的超声诊断

目的 评价超声在精索鞘膜腔积液(spermatic cord hydrpcele SCH)的诊断及鉴别诊断中的价值。方法 对55例超声诊断为精索鞘膜腔积液患进行回顾性分析。结果 55例患均被外科手术及临床证实，超声诊断符合率达到100％。其中44例为局限性精索鞘膜腔积液(topical hydrocele TH)，11例为交通性精索鞘膜腔积液(commumicating hydrocle CH)。6例患囊肿内见分隔光带回声，9例内见光点漂浮，均为局限性精索鞘膜腔积液。1例囊壁厚3mm，术后诊断为合并感染。结论 超声在精索鞘膜腔积液的诊断和鉴别诊断中是一种非常敏感和准确的方法。     

高频超声诊断小儿精索囊肿

目的　探讨高频超声在小儿精索囊肿中的诊断价值。方法　 2 6例均为男孩 ,临床及超声检查为无痛性阴囊或腹股沟区肿块。所有病例均经手术及随访证实。结果　囊肿发生于单侧 2 5例 ,双侧 1例。大小 6 .8cm× 3.0 cm～ 1.5 cm× 0 .8cm。囊肿为单房 2 5例 ,双房 1例。 3例囊肿内见光点及光带反射 ,余透声好。形状为椭圆形或梭形 2 1例 ,类三角形 5例 (尖端指向腹股沟 )。位于腹股沟 10例 ,位于阴囊 16例。合并同侧及双侧睾丸鞘膜积液各 1例。彩色多普勒观察囊肿内未见明显血流信号。结论　精索囊肿又称精索鞘膜积液 ,是鞘膜积液的4种类型之一。高频超声做为一种无创伤性检查方法 ,对诊断精索囊肿有很高的特异性 ,为临床诊断及治疗提供较可靠的信息。     

Malignant fibrous histiocytoma of the spermatic cord: case report and literature review

This case study reports on a rare case of malignant fibrous histiocytoma arising in the right spermatic cord. An 80-year old male presented with a 2-week history of a right inguinal mass, with mild pain in the same region. Ultrasonography and computed tomography showed a mass arising from the right spermatic cord. A right radical orchiectomy was performed with wide dissection of the mass; the right testicle and epididymis were found not to be grossly involved. The patient had an uneventful postoperative course and recovered well. The patient and his family refused further adjuvant radiotherapy. There was no evidence of recurrence or metastasis during 20 months of regular follow-up. The diagnosis, histological classification, treatment and prognosis of this case are presented, together with a review of the literature.     

高频超声诊断腹股沟肿块的研究

目的探讨高频超声对腹股沟肿块的诊断价值。方法应用高频超声对196例腹股沟肿块进行检查并诊断。全部经手术或病理证实。结果腹股沟疝89例，隐睾(腹股沟型)59例，鞘膜积液26例，淋巴结转移癌10例，精索囊肿6例。鞘膜结核6例。超声诊断符合率92．35％。结论高频超声对腹股沟肿块的诊断有重要临床价值。可作为腹股沟肿块的首选影像学诊断方法。