McAlister W H, Sisler C L
Washington University School of Medicine, St. Louis Children's Hospital, Mallinckrodt Institute of Radiology, MO.
Curr Probl Diagn Radiol. 1990 Nov-Dec;19(6):201-42. doi: 10.1016/0363-0188(90)90010-f.
In this review we will attempt to summarize the use of scrotal sonography in infants and children. The material is gathered from the literature and from our own experience of 197 sonograms performed on 175 pediatric patients. Included will be information on testicular development and descent, normal sonographic anatomy, classification of scrotal disease, and the final diagnoses of the sonograms. Scrotal sonography has proven useful in evaluating undescended testes in the inguinal canal and just inside the inguinal ring. It is of limited value when the testes are in the abdomen. Sonography can often distinguish the various causes of nonpainful scrotal masses such as tumors, hydrocele, and meconium peritonitis. Sonography is highly accurate in distinguishing normal from abnormal scrotal contents and in separating testicular from extratesticular masses. However, sonography does have limitations in distinguishing benign from malignant neoplasms or from some inflammatory lesions. Sonography can be successfully used in the differential diagnosis of the painful scrotum especially with color flow Doppler. Inflammatory diseases that often involve the epididymis can be distinguished from torsion. Torsion of the appendages has been diagnosed. In cases of scrotal trauma, management decisions are often based on the sonographic findings. Conditions that require surgical management such as testicular rupture or large testicular hematomas can be recognized. Information is included on a variety of miscellaneous conditions such as hydrocele, varicocele, and ambiguous genitalia in which sonography has proven valuable.
在本综述中，我们将尝试总结阴囊超声在婴幼儿及儿童中的应用。材料收集自文献以及我们对175例儿科患者进行的197次超声检查的自身经验。内容将包括睾丸发育与下降、正常超声解剖、阴囊疾病分类以及超声检查的最终诊断信息。阴囊超声已被证明在评估腹股沟管及腹股沟环内的隐睾时很有用。当睾丸位于腹腔内时，其价值有限。超声检查通常能够区分无痛性阴囊肿块的各种病因，如肿瘤、鞘膜积液和胎粪性腹膜炎。超声在区分正常与异常阴囊内容物以及区分睾丸肿块与睾丸外肿块方面高度准确。然而，超声在区分良性与恶性肿瘤或某些炎性病变方面确实存在局限性。超声检查，尤其是彩色多普勒超声，可成功用于阴囊疼痛的鉴别诊断，可以区分常累及附睾的炎性疾病与睾丸扭转。附件扭转也已得到诊断。在阴囊外伤的病例中，治疗决策通常基于超声检查结果。可以识别出需要手术治疗的情况，如睾丸破裂或巨大睾丸血肿。还包括了超声检查已证明有价值的各种其他情况的信息，如鞘膜积液、精索静脉曲张和两性畸形。
