彩色多普勒血流显像技术在睾丸扭转诊断与随访的应用价值

目的探讨彩色多普勒血流显像（color doppler flow imaging，CDFI）技术在睾丸扭转的诊断与随访中的临床应用价值。方法17例睾丸扭转患者，术前均经CDFI诊断，其中发病至确诊〈6h者6例，1例手法复位，5例手术复位；12～24h者4例，1例手术复位，3例行睾丸切除术；〉48h的7例均切除睾丸。结果17例患者诊断符合率100％，CDFI显示扭转睾丸其最大径较健侧缩小，血流峰值速度降低，阻力指数升高（P〈0．05）。睾丸扭转切除率为58．8％（10／17）。保留睾丸的7例中，4例随访3年，3例随访6个月，其中1例术后伤口感染，睾丸坏死并自行排出体外，2例睾丸复位后萎缩。结论CDFI技术是诊断急性睾丸扭转的首选方法，同时对扭转睾丸复位后的随访也具有临床意义。

The Value of Color Doppler Flow Imaging in Diagnosis and Prognosis of Testicular Torsion

Objective To discuss the role of color Doppler flow imaging （CDFI） in diagnosis and follow-up of testicular torsion. Methods 17 patients who suffered testicular torsion were diagnosed by CDFI. 6 cases were diagnosed definitely in 6 hours from onste, and were treated by manual reduction in 1 case and surgical reduction in 5 cases. Four cases were diagnosed between 12 to 24 hours, and were performed surgical reduction in 1 case and orchectomy in 3 cases. The other 7 cases diagnosed definitely more than 48 hours were executed orchectomy. Results CDFI showed the maximum diameter was shorter, peak velocity of blood flow was lower, and resistance index was higher in involved side than those in uninvolved side of torsional testicle （ P 〈 0. 05 ）. The diagnose accordance rate was 100 % in 17 cases. The resection rate of torsional testicle was 58.8% （ 10/17 ）. Among the torsional testicle reserved cases, 4 were followed up for 3 years and 3 were 6 months. One case occurred incision infection, testis necrosis and effluence. The orchiatrophy rate was 33.3% in torsional testicle reserved patients. Conclusions CDFI would be the first selection to diagnosis testicular torsion. It can play an important role to forecast the prognosis of reductive testicle.