阴囊、睾丸损伤的CT诊断与临床分析

目的提高阴囊、睾丸损伤的诊治水平。方法对23例闭合性阴囊、睾丸损伤的CT资料及临床处理进行回顾性分析。结果CT正确显示诊断了睾丸破裂，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。保守治疗痊愈6例：2例单纯性阴囊壁血肿、1例少量鞘膜积血、1例创伤性附睾炎伴精素囊肿，2例单纯性睾丸内血肿；手术治疗痊愈17例：血肿清除8例、弥漫性睾丸挫伤行白膜开窗减压术1例、睾丸重建5例、睾丸切除3例。结论CT能准确诊断各种类型的阴囊睾丸损伤，并准确估计其损伤程度和范围。轻度阴囊睾丸损伤均可保守治愈，中度阴囊睾丸损伤应早期手术治疗，重度阴囊睾丸损伤应做睾丸切除。

The diagnosis by computerized tomography and the clinical analyses of the patients with injury of scrotum and testis

Objectives To improve the diagnosis levels of the patients who had the injury of scrotum and testis.Methods Retrospective analyses were carried out with the data of CTand the methods of clinical treatment in23cases with the injury of scrotum and testis.Results CT can accurately show the pictures of pathological changes,such as rupture of testis,haematoma of scrotal wall,vaginal haematocele,haematoma belowtunica albuginea testis,haematoma of parenchyma testis,contusion of testis and epididymis,haematoma of spermatic cord and epididymis,etc.Of6cases were recovered from non-operative treatment:2cases had simple haematomas of scrotal wall,1case had small amount of hematocele in vagina,1case had traumatic epididymitis concomitant a semen cyst and2cases had simple haematomas inside testis.Of17cases were recovered from operative treatment:8cases were the operations of clearing haematomas,1case with the contusion of diffuse testis was performed an operation of windowing decompression on lunica albuginea testis,5cases were performed the operations of rebuilding testes and3cases were done the removal of testes.Conclusions The picture of CTcan accurately showvarious types of the injury of scrotum and testis,and injured degrees and limits.The patients with the light injury of scrotum and testis can recover from non-operative treatment,The patients with the middle injury of scrotumand testis must be performed operative treatment and the patients with the sever injury of scrotum and testis must be underdone the resection of testes.