Rizvi Syed Amjad Ali, Ahmad Ibne, Siddiqui Mohammed Azfar, Zaheer Samreen, Ahmad Kaleem
Department of Surgery, Jawaharlal Nehru Medical College, A.M.U., Aligarh, India.
Urol J. 2011 Winter;8(1):60-5.
To determine the value of color Doppler ultrasonography (CDUS) as a routine investigational method for diagnosis of scrotal pathologies.
This prospective observational study (case series) was carried out over a period of 16 months on 122 patients in the age range of 13 to 70 years old, who presented with scrotal swellings. After adequate history taking and examination, CDUS was performed. The diagnosis of the surgeon and that of radiologist were compared with final outcome, which was based on course and outcome of the disease, fine needle aspiration cytology results, and operative findings.
The final diagnoses were epididymitis or epididymo-orchitis (46), hydrocele (26), varicocele (16), testicular malignancy (16), orchitis (6), testicular torsion (4), spermatic cord injury (2), hematocele (2), and pyocele (2). Color Doppler ultrasonography accurately diagnosed all cases of epididymitis or epididymo-orchitis, spermatic cord injury, testicular torsion, varicocele, and hydrocele (sensitivity 100% and specificity 100%). Of 16 subjects diagnosed as testicular malignancy on CDUS, only 14 were subsequently found to have malignancy. Two cases of orchitis were wrongly diagnosed as malignancy. Similarly, of 6 patients diagnosed as orchitis, 1 was found to have seminoma (sensitivity 87.5% and specificity 66.7%). Overall sensitivity of CDUS in diagnosing scrotal diseases was 98% while specificity was 66.7%.
Color Doppler ultrasonography is an excellent, a safe, and reliable method for evaluating patients with scrotal diseases. It aids in diagnosis of testicular tumors and reduces the number of unnecessary exploratory operations. It is especially important in conditions like testicular torsion where immediate diagnosis is required.
确定彩色多普勒超声检查（CDUS）作为诊断阴囊病变常规检查方法的价值。
这项前瞻性观察性研究（病例系列）对122例年龄在13至70岁之间出现阴囊肿胀的患者进行了为期16个月的研究。在进行充分的病史采集和检查后，进行了CDUS检查。将外科医生和放射科医生的诊断与基于疾病病程和结局、细针穿刺细胞学检查结果以及手术所见的最终结果进行比较。
最终诊断为附睾炎或附睾睾丸炎（46例）、鞘膜积液（26例）、精索静脉曲张（16例）、睾丸恶性肿瘤（16例）、睾丸炎（6例）、睾丸扭转（4例）、精索损伤（2例）、阴囊血肿（2例）和阴囊积脓（2例）。彩色多普勒超声准确诊断了所有附睾炎或附睾睾丸炎、精索损伤、睾丸扭转、精索静脉曲张和鞘膜积液病例（敏感性100%，特异性100%）。在CDUS诊断为睾丸恶性肿瘤的16例患者中，随后仅发现14例患有恶性肿瘤。2例睾丸炎被误诊为恶性肿瘤。同样，在诊断为睾丸炎的6例患者中，1例被发现患有精原细胞瘤（敏感性87.5%，特异性66.7%）。CDUS诊断阴囊疾病的总体敏感性为98%，特异性为66.7%。
彩色多普勒超声是评估阴囊疾病患者的一种优秀、安全且可靠的方法。它有助于诊断睾丸肿瘤并减少不必要的探查手术数量。在睾丸扭转等需要立即诊断的情况下尤为重要。
