Meza M P, Amundson G M, Aquilina J W, Reitelman C
Department of Radiology, Children's Hospital of Michigan, Detroit.
Pediatr Radiol. 1992;22(5):370-3. doi: 10.1007/BF02016260.
32 boys with symptoms of an acute scrotum had testicular sonography with color flow imaging (CFI). Patients ranged in age from 4-15 years (avg = 11 yrs). Symptoms were present from 12 h to 5 days (avg = 42 hrs). CFI correctly predicted presence or absence of testicular perfusion in 11 boys who had surgical exploration of the scrotum. 8 of these 11 patients had hemorrhagic infarction of the testicle, 1 had torsion of the appendix epididymis, 1 had epididymitis, and 1 had bilateral incomplete torsions with normal testicular perfusion. The remaining 21 patients did not have an operation. At least a 1 year follow-up of all patients has shown no clinical evidence of testicular atrophy to suggest a missed diagnosis of torsion. Absence or markedly decreased testicular flow was easily identified and indicates testicular ischemia/infarction. Conversely, hyperemia of the testis and/or epididymis is usually associated with trauma or infection. However, incomplete torsion or spontaneous detorsion may demonstrate normal testicular flow on CFI. Only close correlation of clinical symptomatology and gray scale findings with CFI can identify these patients, who remain at high risk for subsequent complete torsion and infarction.
32名有急性阴囊症状的男孩接受了彩色多普勒血流成像（CFI）睾丸超声检查。患者年龄在4至15岁之间（平均11岁）。症状出现时间为12小时至5天（平均42小时）。CFI正确预测了11名接受阴囊手术探查男孩的睾丸灌注情况。这11名患者中，8例为睾丸出血性梗死，1例为附睾附件扭转，1例为附睾炎，1例为双侧不完全扭转且睾丸灌注正常。其余21名患者未进行手术。对所有患者至少进行了1年的随访，未发现有睾丸萎缩的临床证据提示漏诊扭转。睾丸血流缺失或明显减少易于识别，提示睾丸缺血/梗死。相反，睾丸和/或附睾充血通常与创伤或感染有关。然而，不完全扭转或自发扭转复位在CFI上可能显示睾丸血流正常。只有将临床症状、灰阶表现与CFI密切关联，才能识别出这些患者，他们随后发生完全扭转和梗死的风险仍然很高。
