Tarantino L, Giorgio A, de Stefano G, Farella N
Ultrasound Service, D. Cotugno Hospital for Infectious Diseases, Naples, Italy.
J Ultrasound Med. 2001 Nov;20(11):1189-95. doi: 10.7863/jum.2001.20.11.1189.
To describe echo color Doppler features of mumps epididymo-orchitis in postpubertal boys and men.
Color Doppler ultrasonographic examinations of the scrotum in 12 patients (14-34 years old) with serologically proven mumps and symptomatic epididymo-orchitis (pain and scrotal swelling) were compared with color Doppler ultrasonographic examinations of the scrotum in 10 healthy control subjects.
Clinically evident testicular involvement was bilateral in 1 patient and unilateral in 11 patients (9 left- and 2 right-sided). Four (33.3%) of 12 patients had swelling and a heterogeneous echo texture of the epididymis and hydrocele. Two (16.7%) of 12 patients had swelling of both the epididymis and didymus of the involved side, with a heterogeneous echo texture of the didymus due to hypoechoic, irregularly shaped, confluent intraparenchymal areas. Two (16.7%) of 12 patients had only unilateral mild hydrocele and no testicular abnormalities. In 4 (33.3%) of 12 cases, B-mode ultrasonographic examination did not show any testicular abnormalities or hydrocele. Hydrocele was anechoic in 4 cases and multiseptated in 4. In 12 (100%) of 12 patients, color Doppler and power Doppler ultrasonography showed hypervascularity in the parenchyma of the affected testicle. In 11 patients, spectral Doppler examination of the arteries at the testicular hilum showed a significantly lower mean +/- SD resistive index (0.54 +/- 0.03; range, 0.48-0.57) on the inflamed side compared with the opposite unaffected side (mean, 0.66 +/- 0.04; range, 0.71-0.60) (P < .001). In the patient with bilateral involvement, the mean resistive index values in the right and left testicular arteries were 0.57 and 0.55, respectively. The mean resistive index of the 13 inflamed testicles (0.54 +/- 0.03; range, 0.48-0.57) was significantly different from the mean resistive index values of the right (0.68 +/- 0.03) and left (0.67 +/- 0.04) testicular arteries in healthy control subjects (P < .001). The mean resistive index in the 11 unaffected testicles in our patients (0.66 +/- 0.04; range, 0.71-0.60) was not significantly different from the mean resistive index in healthy control subjects. CONCLUSION. Ultrasonographic findings in mumps orchitis are not specific. Echo color Doppler examination is more sensitive than ultrasonography alone for revealing testicular inflammation.
描述青春期后男孩和男性流行性腮腺炎附睾炎的超声彩色多普勒特征。
对12例（年龄14 - 34岁）血清学确诊为流行性腮腺炎且有症状性附睾炎（疼痛和阴囊肿胀）患者的阴囊进行彩色多普勒超声检查，并与10例健康对照者的阴囊彩色多普勒超声检查结果进行比较。
临床上明显的睾丸受累情况为1例双侧受累，11例单侧受累（9例左侧，2例右侧）。12例患者中有4例（33.3%）附睾肿胀，回声不均匀，伴有鞘膜积液。12例患者中有2例（16.7%）患侧附睾和睾丸均肿胀，睾丸内可见低回声、形状不规则且融合的实质内区域，导致回声不均匀。12例患者中有2例（16.7%）仅单侧有轻度鞘膜积液，无睾丸异常。12例中有4例（33.3%）B超检查未显示任何睾丸异常或鞘膜积液。鞘膜积液4例为无回声，4例为多房性。12例患者（100%）的彩色多普勒和能量多普勒超声检查均显示患侧睾丸实质内血流增多。11例患者患侧睾丸门部动脉的频谱多普勒检查显示，与对侧未受累侧相比，患侧平均±标准差阻力指数显著降低（0.54±0.03；范围0.48 - 0.57），对侧平均阻力指数为0.66±0.04（范围0.71 - 0.60）（P <.001）。双侧受累患者右侧和左侧睾丸动脉的平均阻力指数分别为0.57和0.55。13个患侧睾丸的平均阻力指数（0.54±0.03；范围0.48 - 0.57）与健康对照者右侧（0.68±0.03）和左侧（0.67±0.04）睾丸动脉的平均阻力指数有显著差异（P <.001）。患者中11个未受累睾丸的平均阻力指数（0.66±0.04；范围0.71 - 0.60）与健康对照者的平均阻力指数无显著差异。结论：流行性腮腺炎睾丸炎的超声表现不具有特异性。超声彩色多普勒检查在发现睾丸炎症方面比单纯超声检查更敏感。
