隐睾症的诊断影像学：效用、适应证和效果。
Diagnostic imaging in cryptorchidism: utility, indications, and effectiveness.
机构信息
Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
出版信息
J Pediatr Surg. 2011 Dec;46(12):2406-13. doi: 10.1016/j.jpedsurg.2011.08.008.
BACKGROUND
Cryptorchidism (undescended testis) is the most common genitourinary anomaly in male infants.
METHODS
We reviewed the available literature on the diagnostic performance of ultrasound, computed tomography, and magnetic resonance imaging (MRI) in localizing undescended testes.
RESULTS
Ultrasound is the most heavily used imaging modality to evaluate undescended testes. Ultrasound has variable ability to detect palpable testes and has an estimated sensitivity and specificity of 45% and 78%, respectively, to accurately localize nonpalpable testes. Given the poor ability to localize nonpalpable testes, ultrasound has no role in the routine evaluation of boys with cryptorchidism. Magnetic resonance imaging has greater sensitivity and specificity but is expensive, not universally available, and often requires sedation for effective studies of pediatric patients. Diagnostic laparoscopy has nearly 100% sensitivity and specificity for localizing nonpalpable testes and allows for concurrent surgical correction.
CONCLUSIONS
Although diagnostic imaging does not have a role in the routine evaluation of boys with cryptorchidism, there are clinical scenarios in which imaging is necessary. Children with ambiguous genitalia or hypospadias and undescended testes should have ultrasound evaluation to detect the presence of müllerian structures.
背景
隐睾症（睾丸未降）是男性婴儿中最常见的泌尿生殖系统异常。
方法
我们回顾了关于超声、计算机断层扫描和磁共振成像（MRI）在定位未降睾丸方面的诊断性能的现有文献。
结果
超声是评估未降睾丸最常用的成像方式。超声检测可触及睾丸的能力存在差异，其准确定位不可触及睾丸的敏感性和特异性分别为 45%和 78%。鉴于定位不可触及睾丸的能力较差，超声在隐睾症男孩的常规评估中没有作用。磁共振成像具有更高的敏感性和特异性，但价格昂贵，并非普遍可用，并且经常需要镇静才能对儿科患者进行有效的研究。诊断性腹腔镜检查对定位不可触及的睾丸具有近 100%的敏感性和特异性，并允许同时进行手术矫正。
结论
尽管诊断性影像学在隐睾症男孩的常规评估中没有作用，但在某些临床情况下，影像学是必要的。具有生殖器模糊或尿道下裂和未降睾丸的儿童应进行超声检查以检测米勒管结构的存在。
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