van der Sluijs Jan Willem, den Hollander Jan C, Lequin Maarten H, Nijman Rien M, Robben Simon G F
Department of Pediatric Radiology, Sophia Children's Hospital, Dr Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
Eur Radiol. 2004 Feb;14(2):250-5. doi: 10.1007/s00330-003-2019-0. Epub 2003 Sep 4.
The aim of this study was to demonstrate the ultrasonographic features of prenatal torsion of the testis at presentation and during follow-up, with histological correlation post-orchidectomy. Between January 1985 and December 1999, 13 neonates with antenatal torsion of the testis were examined postnatally, at presentation and during follow-up, with high-resolution ultrasonography, including colour Doppler ultrasonography. Bilateral testis volume was evaluated [lengthxwidthxdepthx(pi/6)]. Ultrasonographic findings were correlated with histological findings (n=8) and findings at surgery. Moreover, in 1 patient the affected testis was postoperatively examined with ultrasonography in vitro. These findings were correlated with preoperative ultrasonography and corresponding histological slices. All patients (n=13) presented with a painless congenital scrotal mass. On the affected side no flow was found with colour Doppler ultrasonography. Testis volume on the affected and normal side showed mean values of 2.1 and 0.5 cc, respectively. On ultrasonography all patients showed scrotal swelling and a heterogeneous testis with hypoechoic central areas (necrosis). The tunica albuginea was thickened in all patients, with focal (n=2) or rim-like (n=11) hyperechoic reflections (calcifications) at the transitional zone between testis and tunica albuginea. In 9 patients follow-up ultrasonography showed progressive testis atrophy on the affected side. In 10 patients a contralateral hydrocele was found. Prenatal torsion shows a characteristic ultrasonographic pattern. In newborns with a scrotal mass, these ultrasonographic findings should suggest this diagnosis and delay in immediate surgery and/or oncological work-up may be appropriate.
本研究的目的是展示睾丸产前扭转在就诊时及随访期间的超声特征，并与睾丸切除术后的组织学结果进行对照。1985年1月至1999年12月期间，对13例产前睾丸扭转的新生儿在出生后、就诊时及随访期间进行了高分辨率超声检查，包括彩色多普勒超声检查。评估双侧睾丸体积[长×宽×深×(π/6)]。超声检查结果与组织学结果（n=8）及手术结果进行对照。此外，对1例患者术后的患侧睾丸进行了体外超声检查。这些结果与术前超声检查及相应的组织学切片进行对照。所有患者（n=13）均表现为无痛性先天性阴囊肿块。患侧彩色多普勒超声检查未发现血流信号。患侧和正常侧睾丸体积的平均值分别为2.1 cc和0.5 cc。超声检查显示所有患者均有阴囊肿胀，睾丸回声不均匀，中央区域为低回声（坏死）。所有患者的白膜均增厚，在睾丸与白膜的过渡区有局灶性（n=2）或环状（n=11）高回声反射（钙化）。9例患者随访超声检查显示患侧睾丸逐渐萎缩。10例患者发现对侧鞘膜积液。产前扭转呈现出特征性的超声图像。对于有阴囊肿块的新生儿，这些超声检查结果应提示该诊断，延迟立即手术和/或肿瘤学检查可能是合适的。
