彩色多普勒超声在睾丸扭转中的应用价值

目的探讨彩色多普勒超声在睾丸扭转中的应用价值。方法回顾分析15例睾丸扭转的二维超声表现,应用CDFI观察其血供状况,并与临床、手术及病理结果进行对照分析。结果 15例睾丸扭转患者中,患侧睾丸内血流消失5例,血流明显减少8例,血流无明显变化2例。超声准确诊断13例,2例误诊为急性睾丸炎。结论彩色多普勒超声对睾丸扭转的诊断准确率较高,对临床治疗方案的选择有重要的指导意义。     

急性实验性睾丸不全扭转的脉冲波多普勒超声表现

目的 探讨急性实验性睾丸不全扭转的脉冲波多普勒(PWD)表现.方法 健康杂种犬8只,随机选择一侧精索扭转,分别扭转180°～630°.于扭转前、扭转后2、4、6 h用PWD观察测量双侧睾丸内动脉、睾丸包膜动脉及精索内动脉的收缩期峰值流速(PSV)及阻力指数(RI).试验结束后将睾丸送病理检查.结果 睾丸内动脉及睾丸包膜动脉PSV及RI随扭转时间延长而逐渐降低,与扭转时间拟合的曲线回归分析有统计学意义(P<0.05).精索扭转上段、扭转段及扭转下段内动脉PSV及RI变化范围较大且规律性不强(P>0.05).病理结果显示扭转侧睾丸无明显变化或仅表现为轻度间质充血、水肿.结论 睾丸包膜动脉及睾丸内动脉PSV、RI降低,特别是RI降低对判断急性期实验性睾丸不全扭转有参考价值,而精索扭转上段、扭转段及扭转下段内动脉PSV、RI变化并非判断急性期实验性睾丸不全扭转的可靠指标.     

高频及彩色多普勒超声诊断睾丸扭转的价值

目的 探讨高频及彩色多普勒超声在睾丸扭转中的临床诊断价值。方法 回顾分析6例睾丸扭转病例，总结其发病及诊断过程。结果 6例睾丸扭转患者均经手术证实，其中4例睾丸坏死。结论 结合临床有针对性地进行高频及彩色多普勒超声检查对早期诊断睾丸扭转有重要意义。     

彩色多普勒超声诊断和鉴别诊断小儿睾丸扭转

目的 评估彩色多普勒超声诊断及鉴别诊断小儿睾丸扭转的价值。 方法 回顾分析因急性阴囊肿痛而接受彩色多普勒超声检查的125例患儿的声像图特征,并与手术病理、临床最终诊断相比较。 结果 125例中,急性睾丸扭转14例,超声诊断符合率92.86%(13/14),均接受手术治疗,其中11例睾丸完全坏死切除,CDFI显示睾丸内无明显血流信号,3例手术复位后睾丸存活,CDFI示睾丸内有少量血流信号;急性睾丸附件扭转68例,睾丸上极或与附睾间见回声不均质结节,内无血流信号,超声诊断符合率97.06%(66/68);急性附睾炎43例,附睾内血流信号明显增多,超声诊断符合率100%(43/43)。 结论 彩色多普勒超声对小儿睾丸扭转具有较高的诊断及鉴别诊断价值,是临床首选的影像检查方法。     

Sonographic differential diagnosis of acute scrotum: real-time whirlpool sign, a key sign of torsion.

Objective. The purpose of this study was to prospectively investigate the role of high‐resolution and color Doppler sonography in the differential diagnosis of acute scrotum and testicular torsion in particular. Methods. Patients who underwent sonography for acute scrotum between April 2000 and September 2005 were included in the study. Gray scale and color Doppler sonography of the scrotum was performed. The spermatic cord was studied on longitudinal and transverse scans from the inguinal region up to the testis, and the whirlpool sign was looked for. Results. During this period, 221 patients underwent sonography for acute scrotum. Sixty‐five had epididymo‐orchitis with a straight spermatic cord, a swollen epididymis, testis, or both, an absent focal lesion in the testis, and increased flow on color Doppler studies along with the clinical features of infection. Three had testicular abscesses. Sonography revealed features of torsion of testicular appendages in 23 patients and acute idiopathic scrotal edema in 19. Complete torsion was seen in 61 patients who had the whirlpool sign on gray scale imaging and absent flow distal to the whirlpool. There was incomplete torsion in 4 patients in whom the whirlpool sign was seen on both gray scale and color Doppler imaging. Nine patients had segmental testicular infarction, and 1 had a torsion‐detorsion sequence revealing testicular hyperemia. In 14 patients, the findings were equivocal. There was a complicated hydrocele, mumps orchitis, and vasculitis of Henoch‐Schönlein purpura in 1 patient each. Five patients had normal findings. Fourteen were lost for follow‐up. Conclusions. Sonography of acute scrotum should include study of the spermatic cord. The sonographic real‐time whirlpool sign is the most specific and sensitive sign of torsion, both complete and incomplete. Intermittent testicular torsion is a challenging clinical condition with a spectrum of clinical and sonographic features.     

实验性睾丸不全扭转的彩色多普勒超声研究

目的探讨实验性睾丸扭转的早期彩色多普勒超声特征。方法选用6只健康杂种犬,制成12个睾丸不全扭转模型。应用7～14MHz探头,连续24h观察扭转前、后不同时段睾丸及精索彩色多普勒超声表现,并与相应时段睾丸穿刺活检病理结果对比研究。结果扭转后睾丸体积较扭转前显著增大(P<0.05),睾丸在血流信号消失后开始出现不均匀回声,扭转上段的睾丸动脉阻力指数较扭转前显著增高(P<0.05),扭转下段睾丸动脉、睾丸包膜动脉及睾丸内动脉血流阻力指数较扭转前显著降低(P<0.05)。病理结果显示睾丸在不同时段发生不同程度的损害。结论睾丸不全扭转24h内的动态超声表现揭示了睾丸扭转早期血流动力学变化的病理基础,为临床早期诊断睾丸扭转提供较可靠的实验依据。     

Intermittent torsion of a normal ovary in a child associated with use of a trampoline

Background

Ovarian torsion is rare in children. It usually occurs in the presence of ovarian or pelvic pathology. The course of symptoms is typically hours to days. Some authors have speculated that sudden acceleration/deceleration movements may precipitate torsion.

Objectives

The objective of this report is to describe a case of intermittent abdominal pain lasting nearly 6 months, which started when the child began playing regularly on a trampoline, and was ultimately diagnosed as intermittent ovarian torsion of an otherwise normal ovary.

Case Report

A 12-year-old girl presented to the Emergency Department (ED) with 2 h of abdominal pain and vomiting. She reported similar episodes over the previous 6 months. Initial ultrasound, obtained between episodes, was normal. Repeat ultrasound at ED presentation showed no blood flow to the left adnexa. Surgery confirmed the ovary to be twisted 1080 degrees and markedly edematous due to vascular engorgement. The family retrospectively identified the onset of the first episode as happening the same week the child had begun playing regularly on a trampoline. After surgery, she no longer played on the trampoline. At follow-up 22 months later, she had had no recurrence of her symptoms.

Conclusion

Intermittent ovarian torsion should be considered as a rare cause of recurrent abdominal pain in children. The presence of blood flow with Doppler ultrasound during acute symptoms does not exclude the diagnosis. Clinicians might also ask about unusual physical activities because several authors have theorized that ovarian torsion could be precipitated by sudden acceleration/deceleration movements.     

Non‐operative management of primary omental torsion,a case report and literature review

Primary omental torsion is a rare cause of acute abdomen especially in obese patients with inconsistent history, examination, and laboratory findings. The liberal use of computed tomography in casualties has increased its preoperative diagnosis. Despite the controversy, the non‐operative approach should be attempted as a first line of management while the laparoscopic resection should be only considered after failure of non‐operative management.     

彩色多普勒超声诊断卵巢扭转的价值再探讨

目的探讨彩色多普勒超声对卵巢扭转的诊断价值。方法应用彩色多普勒超声对经手术后病理证实的13例卵巢扭转进行综合分析。结果3例为单纯性卵巢扭转,超声均准确诊断;10例为卵巢肿物伴扭转,超声准确诊断9例,1例误诊为卵巢黄体血肿。诊断符合率92．3％。结论彩色多普勒超声诊断卵巢扭转有较高的敏感性和特异性,具有较高的临床应用价值。     

彩色多普勒对青少年睾丸扭转诊断及治疗的评价

目的应用彩色多普勒(CDFI)探索青少年睾丸扭转能否成功进行手法复位提供依据。方法对45例睾丸扭转患者首先用二维超声显示双侧睾丸结构及内部回声,再用彩色多普勒观察血供情况,详细记录双侧睾丸动脉的收缩期峰值流速(PSV)及阻力指数(RI),手法复位后2小时再分别记录上述检测指标。结果手法复位成功组(27例),PSV:4.2±0.7(cm/s),RI:0.28±0.07,复查CDFI显示,血流恢复正常,疼痛症状缓解,8例手法复位失败后进行手术及10例直接进入手术治疗,该组共18例,PSV:1.7±0.4(cm/s),RI:0.81±0.09。结论彩色多普勒检测对睾丸扭转诊断及指导手法复位具有很高的临床应用价值.     

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     

睾丸扭转的高频彩超诊断及临床分析

目的 探讨高频彩色多普勒超声在睾丸扭转诊断中的价值,提高睾丸扭转的诊治水平。方法 回顾性分析28例睾丸扭转病例的临床资料,总结分析其临床表现及CDFI声像图特征。结果 28例睾丸扭转患者高频彩超显示睾丸、附睾在阴囊内位置、内部回声改变,睾丸内血流减少或消失。所有病例均经手术证实。结论 高频彩色多普勒超声为睾丸扭转首选检查方法,结合临床表现可确诊睾丸扭转。     

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.     

高、低频超声造影与彩超对睾丸扭转的诊断比较

目的应用高、低频超声造影对比彩超观察睾丸扭转的微循环灌注表达的差别。方法对16例可疑睾丸扭转的病例,进行彩超及高、低频超声造影的检查,并将其图像进行对比。结果彩超对睾丸实质内的血流检出较为敏感,但仍有部分病例在初诊时无法判断,经高、低频超声造影后,正常睾丸实质出现较丰富的造影剂显像,而扭转的睾丸则出现灌注缺失。结论睾丸扭转的超声造影诊断可以利用高低频相结合,使造影剂的显影更为敏感,是彩超的有效补充手段。     

彩色多普勒超声对睾丸附件扭转的诊断价值

目的 探讨彩色多普勒超声对睾丸附件扭转的诊断价值.方法 回顾性分析我院经手术或临床随访证实的35例睾丸附件扭转患者的声像图资料.结果 所有患者均可在睾丸上极与附睾头附近探及一非均质高回声结节,结节内未探及血流信号;22例患者同时伴有同侧睾丸及附睾轻度增大,且彩色多普勒血流信号较对侧相对增多;24例患者伴有同侧精索增粗;...     

彩色多普勒超声诊断卵巢肿瘤蒂扭转

目的 探讨彩色多普勒超声诊断卵巢肿瘤蒂扭转的价值.方法 回顾性分析27例经手术和病理证实的卵巢肿瘤蒂扭转患者的超声资料,并根据血管蒂的彩色多普勒表现将其分为3型.随访27例患者的手术及病理结果,与超声表现进行对比分析.结果 本组23例患者于卵巢肿瘤旁可探及扭转血管蒂,呈"双肿块征".其彩色多普勒表现为Ⅰ型4例、Ⅱ型5例...     

彩色多普勒超声检测睾丸扭转的临床价值

目的 探讨彩色多普勒对睾丸扭转的诊断价值。方法 首先用二维超声显示１６例疑为睾丸扭转的睾丸附睾形态结构及内部回声,再用彩色多普勒观察血供状况,并全部以手术病理证实,结果 １５例病例侧睾丸血流消失或减少,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;１例彩超未见血流减少,超声误诊为附睾丸,结论 彩超诊断睾丸扭转正确率高（９３．８％）,具有较高的敏感性和特异性,无创伤,简便易行,且能较