Nashan D, Behre H M, Grunert J H, Nieschlag E
Institute of Reproductive Medicine of the University, Max-Planck Clinical Research Unit for Reproductive Medicine, Münster/Germany.
Andrologia. 1990 Sep-Oct;22(5):387-95. doi: 10.1111/j.1439-0272.1990.tb02013.x.
Scrotal sonography with a 7.5 MHz sector scanner was performed on 658 consecutive patients of our infertility clinic. The incidence of pathological findings was unexpectedly high. Forty per cent of the patients revealed pathological structures such as varicoceles (21%), hydroceles (7%), epididymal abnormalities (6%), spermatoceles (6%), intratesticular hyper- and hypoechoic changes (4.5%), intratesticular cysts (1%) and tumours or carcinoma in situ (CIS) (0.6%). Sonographic evaluation and measurement of the caput epididymidis was compared with palpation. Sonography distinguished size ranges of "normal" and "thickened" epididymides as diagnosed by palpation. Cystic structures were proven in 56% of cases with "thickened" epididymides. The sonographically determined diameters of doppler-negative blood vessels were significantly smaller than those of doppler-positive vessels. Sonography revealed a higher occurrence of varicoceles than diagnosed by palpation (76% by palpation). Only 58% of sonographically identified hydroceles and only 67% of sonographically detected spermatoceles were detected by palpation. One testicular tumour and one case with CIS were only seen by sonography and not suspected on palpation. The results demonstrate that sonography represents a valuable tool in the routine diagnosis of andrological patients.
我们不孕不育门诊对658例连续患者进行了7.5MHz扇形扫描仪阴囊超声检查。病理检查结果的发生率出乎意料地高。40%的患者显示出病理结构，如精索静脉曲张（21%）、鞘膜积液（7%）、附睾异常（6%）、精液囊肿（6%）、睾丸内高回声和低回声改变（4.5%）、睾丸内囊肿（1%）以及肿瘤或原位癌（CIS）（0.6%）。将附睾头的超声评估和测量结果与触诊结果进行了比较。超声能够区分触诊所诊断的“正常”和“增厚”附睾的大小范围。在56%“增厚”附睾的病例中证实存在囊性结构。超声测定的无多普勒血流信号血管直径明显小于有多普勒血流信号的血管。超声显示精索静脉曲张的发生率高于触诊诊断（触诊诊断为76%）。触诊仅检测出58%超声识别出的鞘膜积液和67%超声检测出的精液囊肿。1例睾丸肿瘤和1例原位癌仅通过超声发现，触诊未怀疑。结果表明，超声是男科患者常规诊断中的一种有价值的工具。
