Einstein D M, Paushter D M, Singer A A, Thomas A J, Levin H S
Department of Radiology, Cleveland Clinic Foundation, OH 44195.
Urol Radiol. 1992;14(3):205-10. doi: 10.1007/BF02926932.
All testicular sonograms performed over a 2.5-year period were retrospectively reviewed, yielding eight patients with pathologically proven lesions consisting primarily of tubular sclerosis and interstitial fibrosis. Only two patients (25%) had a palpable abnormality. A variety of sonographic patterns was found, including focal hypoechoic or hyperechoic lesions and diffuse heterogeneity of the testicular parenchyma. The clinical and sonographic findings prompted open biopsy or orchiectomy in all cases. In the same time period, nine pathologically proven testicular malignancies were evaluated sonographically and displayed either well-defined hypoechoic or diffusely heterogeneous echo patterns. All but two of these patients (78%) had palpable abnormalities. This study demonstrates a significant overlap in the sonographic appearance of benign fibrotic lesions and testicular malignancies. When careful palpation of a sonographically heterogeneous or focal hypoechoic lesion fails to reveal a mass and serum tumor markers are negative, an open biopsy with frozen section analysis should be considered rather than proceeding directly to orchiectomy. Homogeneously hyperechoic masses can be considered benign and do not require surgery.
回顾性分析了2.5年期间所有的睾丸超声检查结果，发现8例经病理证实的病变患者，主要病变为小管硬化和间质纤维化。只有2例患者（25%）可触及异常。发现了多种超声图像模式，包括局灶性低回声或高回声病变以及睾丸实质的弥漫性不均匀性。临床和超声检查结果促使所有病例均进行了开放活检或睾丸切除术。在同一时期，对9例经病理证实的睾丸恶性肿瘤进行了超声评估，显示出边界清晰的低回声或弥漫性不均匀回声模式。除2例患者外（78%），所有这些患者均可触及异常。本研究表明，良性纤维化病变和睾丸恶性肿瘤的超声表现存在显著重叠。当对超声检查显示不均匀或局灶性低回声病变进行仔细触诊未发现肿块且血清肿瘤标志物为阴性时，应考虑进行开放活检及冰冻切片分析，而不是直接进行睾丸切除术。均匀高回声肿块可视为良性，无需手术。
