小儿阴囊急症的临床特征和高频超声表现

目的 探讨小儿阴囊急症的临床特征和高频超声表现.方法 分析112例小儿阴囊急症的超声和临床表现,并与最终诊断及治疗方案对照.结果 急性附件扭转65例,超声表现为睾丸上极或附睾头旁回声不均结节,伴或不伴继发反应性炎症.睾丸完全扭转21例,超声示患侧精索螺旋状扭曲成团,睾丸内无明显血流信号;不全扭转4例,患侧精索走行纡曲,睾丸内均可测及少量低阻血流信号.急性睾丸、附睾炎22例,除1例化脓性睾丸炎外,其余病例受累结构血供增多;超声诊断符合率约为98.21%(110/112).三者临床表现虽部分重叠但仍各具特征.15例附件扭转、25睾丸扭转及1例急性睾丸炎接受手术治疗,余均予以保守治疗.结论 客观、准确的急诊超声诊断报告,辅以全面深入的临床资料分析,可为小儿阴囊急症的诊疗提供重要帮助.

High-frequency ultrasound and clinical features of acute scrotum in children

Objective To detect high-frequency ultrasound and clinical features of acute scrotum in children. Methods High-frequency ultrasound and clinical manifestations of 112 children with acute scrotum were analyzed and compared with the final diagnosis and therapeutic regimen. Results Torsion of appendage with uneven echo nodular near the upper pole of testis or head of epididymis, accompanying secondary reactive inflammation or not were detected in 65 children. Complete testicular torsion was found in 21 children who had the whirlpool sign and absent flow in the affected testicle. There was incomplete torsion in 4 patients with winding courser sign and some flow with low resistant index. Flow increased in 22 children with acute epididymo-orchitis, except 1 with suppurative orchitis. The ultrasonic diagnose accordance rate was about 98.21% (110/112). The clinical manifestations of acute scrotum had some characteristics though partial overlapping exited. Fifteen children with torsion of appendage, 25 with complete torsion and 1 with acute orchitis received operation, and the other received expectant treatment. Conclusion The objective and precise emergency ultrasonic diagnosis combined with the overall and profound analysis of related clinical data may provide important information for the diagnosis and treatment of acute scrotum in children.