Attieh Ali, Benelli Andrea, Bertolotto Michele, Simonato Alchiede, Carmignani Giorgio, Derchi Lorenzo E
Radiologia d'Urgenza, IRCCS Azienda Ospedaliera Universitaria S. Martino IST, Genoa, Italy.
Department of Surgical Sciences (DISC), Urology Section, University of Genoa, Genoa, Italy.
J Clin Ultrasound. 2016 Jan;44(1):12-6. doi: 10.1002/jcu.22304. Epub 2015 Sep 24.
To describe the sonographic findings observed in the testis in patients who have undergone testicle-sparing surgery and surgical biopsies.
We reviewed the color Doppler sonographic findings from 14 patients after testicular interventions: 2 open biopsy procedures for infertility and 12 testicle-sparing surgical procedures (1 for spontaneous intratesticular hemorrhage and 11 for small tumors). Ten patients had benign tumors; one had a malignancy. Three patients were symptomatic; all others were studied as follow-up.
Hypoechoic and hypovascular lesions at site of surgery were seen in 10 of the 11 patients after tumorectomy; no changes were observed in one patient. The lesions were either linear or an irregularly triangular shape, located at the surgical site, and interpreted as scars. Retraction of the testicular surface was detected in two cases. In the eight patients who underwent follow-up, lesions disappeared in one case, became smaller in two, and remained stable in five. Of the two patients who underwent biopsy, one developed peritesticular hematoma, and both had late hypoechoic scars in the testis.
Hypoechoic and hypovascular scars are a "normal" postoperative pattern after testicle-sparing surgery. They are either linear or triangular, with rectilinear margins. Such findings need to be correctly interpreted and not misinterpreted as recurrences.
描述接受保留睾丸手术及手术活检患者睾丸的超声检查结果。
我们回顾了14例睾丸干预术后患者的彩色多普勒超声检查结果:2例因不育症接受开放性活检手术,12例接受保留睾丸手术(1例因自发性睾丸内出血,11例因小肿瘤)。10例患者为良性肿瘤;1例为恶性肿瘤。3例患者有症状;其他所有患者均作为随访进行研究。
11例肿瘤切除术后患者中有10例在手术部位可见低回声和低血流信号病变;1例患者未观察到变化。病变呈线性或不规则三角形,位于手术部位,被解释为瘢痕。2例检测到睾丸表面回缩。在接受随访的8例患者中,1例病变消失,2例变小,5例保持稳定。在2例接受活检的患者中,1例发生睾丸周围血肿,2例睾丸均有晚期低回声瘢痕。
低回声和低血流信号瘢痕是保留睾丸手术后的“正常”术后表现。它们呈线性或三角形,边缘直线状。这些发现需要正确解读,而不应误判为复发。