Department of Radiology, King's College London, King's College Hospital, London, United Kingdom.
AJR Am J Roentgenol. 2012 Sep;199(3):W345-54. doi: 10.2214/AJR.11.7997.
The purpose of this study is to determine the effectiveness of contrast-enhanced ultrasound in evaluating incidental focal testicular lesions in epididymitis.
Intratesticular lesions ipsilateral to epididymitis were subject to B-mode color Doppler ultrasound and contrast-enhanced ultrasound, with their appearances reviewed in consensus. Final interpretation was by histologic analysis or follow-up ultrasound.
Over 28 months, 16 focal testicular lesions (median lesion size, 24 mm; range, 14-48 mm) in 14 patients (median age, 49 years; range, 18-81 years) were examined. Lesions were oval (n = 14), wedge shaped (n = 1), or involved the entire testis (n = 1). Lesions were isoechoic (n = 1), hypoechoic (n = 4), or of mixed echogenicity (n = 11). Color Doppler ultrasound flow was not clearly depicted in 13 lesions but was present in three lesions, with contrast-enhanced ultrasound concordant with color Doppler ultrasound, showing unequivocal absence of vascularity and increased flow, respectively. In the avascular lesions, rim enhancement (n = 6), vascular projections (n = 4), and irregular (n = 10) and smooth (n = 2) borders were documented. The observers identified infarction (n = 9), abscess (n = 4), orchitis (n = 1), and tumor (n = 2). Histologic examination (seven lesions in five patients) confirmed infarction, abscess formation, and seminoma; follow-up ultrasound confirmed resolution for eight patients.
Contrast-enhanced ultrasound is a useful adjuvant to color Doppler ultrasound examination of a focal lesion in the testis ipsilateral to epididymitis to improve the characterization of nonvascularized tissue.
本研究旨在确定对比增强超声在评估附睾炎同侧睾丸局灶性病变中的作用。
对同侧附睾的睾丸内病变进行 B 型彩色多普勒超声和对比增强超声检查，并对其外观进行共识评估。最终解释由组织学分析或随访超声检查确定。
在 28 个月的时间里，对 14 例（中位年龄 49 岁；范围 18-81 岁）患者的 16 个睾丸局灶性病变（中位病变大小 24mm；范围 14-48mm）进行了检查。病变呈椭圆形（n=14）、楔形（n=1）或累及整个睾丸（n=1）。病变等回声（n=1）、低回声（n=4）或混合回声（n=11）。13 个病变的彩色多普勒超声血流未清晰显示，但在 3 个病变中显示，增强超声与彩色多普勒超声一致，分别显示明确的无血管性和增加的血流。在无血管性病变中，记录到边缘增强（n=6）、血管突起（n=4）、不规则（n=10）和光滑（n=2）边界。观察者识别出梗死（n=9）、脓肿（n=4）、睾丸炎（n=1）和肿瘤（n=2）。组织学检查（5 例 7 个病变）证实了梗死、脓肿形成和精原细胞瘤；8 例患者的随访超声证实病变消退。
对比增强超声是对附睾炎同侧睾丸局灶性病变进行彩色多普勒超声检查的有用辅助手段，可改善非血管化组织的特征化。
