Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, England.
J Ultrasound Med. 2011 Aug;30(8):1145-50. doi: 10.7863/jum.2011.30.8.1145.
The objective of this series was to show that the sonographic appearance described as the "filarial dance" is not characteristic of filariasis but occurs in nonendemic areas as a manifestation of epididymal obstruction. An experienced observer documented cases after initial observation of the filarial dance in routine clinical practice using high-frequency linear array transducers. The filarial dance was described as excessive to-and-fro movement of echogenic particles within a prominent epididymis and graded 1 to 4 according to the extent and distribution of the abnormality. The country of birth, exposure to filarial infection or travel to a filarial-endemic area, previous scrotal surgery including vasectomy, any previous or current scrotal inflammatory disease, and any congenital testicular abnormalities were recorded. Over a 10-year period, sonographic appearances consistent with the filarial dance were observed in 18 patients (bilateral in 6). The mean patient age was 47.7 (range, 28-91) years. The abnormality was graded in the 24 affected testes as follows: grade 1, n = 3; grade 2, n = 8; grade 3, n = 8; and grade 4, n = 5. No patient had a history of filariasis or travel to an endemic area. Six of 18 patients (33.3%) had bilateral vasectomies; 5 (27.8%) had a history of epididymo-orchitis in the ipsilateral testis; 3 (16.7%) had previous scrotal surgery; and 4 (22.2%) had no relevant urologic history. We have described a sonographic appearance identical to the filarial dance in men with no history of filarial infection. Most had previous scrotal surgery or infection, suggesting that the filarial dance may not always be due to movement of filarial worms. The unifying condition in patients with filariasis and our patients is lymphatic obstruction, likely the underlying cause of the appearance in both groups.
本系列的目的是表明，被描述为“丝虫舞”的超声表现并非丝虫病的特征，而是在非流行地区发生，表现为附睾阻塞。一位经验丰富的观察者在常规临床实践中使用高频线性阵列换能器对丝虫舞进行初步观察后，记录了病例。丝虫舞被描述为在突出的附睾内回声颗粒过度来回移动，并根据异常的程度和分布分为 1 到 4 级。记录了患者的出生地、丝虫感染暴露或前往丝虫流行地区、以前的阴囊手术（包括输精管切除术）、任何以前或当前的阴囊炎症性疾病以及任何先天性睾丸异常。在 10 年期间，18 名患者（6 名双侧）观察到与丝虫舞一致的超声表现。患者的平均年龄为 47.7 岁（范围为 28-91 岁）。24 个受影响的睾丸的异常程度如下：1 级，n = 3；2 级，n = 8；3 级，n = 8；和 4 级，n = 5。没有患者有丝虫病或前往流行地区的病史。18 名患者中有 6 名（33.3%）接受了双侧输精管切除术；5 名（27.8%）同侧睾丸有附睾炎病史；3 名（16.7%）以前有过阴囊手术；4 名（22.2%）无相关泌尿科病史。我们描述了一种与丝虫感染史无关的男性的超声表现与丝虫舞完全相同。大多数患者以前有过阴囊手术或感染，这表明丝虫舞并不总是由丝虫的运动引起的。丝虫病患者和我们的患者的共同点是淋巴阻塞，这可能是两组患者出现这种表现的潜在原因。
