Marcon J, Trottmann M, Stief C G, Clevert D A
Urologische Klinik und Poliklinik, Klinikum der Universität München - Campus Großhadern, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.
Klinik und Poliklinik für Radiologie, Ludwig-Maximilians-Universität München, München, Deutschland.
Radiologe. 2018 Jun;58(6):572-578. doi: 10.1007/s00117-018-0387-3.
The work-up of scrotal diseases forms an essential part of daily work in urology. Sonography plays an important role in the diagnostic process, due to its wide availability and feasibility.
Advantages of modern contrast-enhanced ultrasound (CEUS) are illustrated using examples of common testicular pathologies.
Relevant studies regarding the application of CEUS on testicular pathologies are evaluated. PubMed and Medline were screened for reviews and clinical trials.
In the differentiation of benign and malignant testicular lesions, contrast medium uptake, e. g. can exclude a hemorrhagic testicular cyst. A differentiation between benign and malignant testicular lesions due to pure enhancement is currently not possible. Evaluation of testicular abscesses, infarctions and infections depends on the assessment of vascularization. Following a scrotal trauma, evaluation of enhancement can distinguish between vital and non-vital areas. A complete absence of perfusion may support the diagnosis of testicular torsion.
CEUS is a feasible instrument in the diagnostic work-up of testicular pathologies. Results from previous studies are promising. Regarding the application in cases of scrotal trauma, the method could play an essential role in the future. With regard to a classification of unclear testicular lesions, further studies with a larger number of patients are needed in order to confirm previously described perfusion patterns.
阴囊疾病的检查是泌尿外科日常工作的重要组成部分。超声检查因其广泛的可用性和可行性，在诊断过程中发挥着重要作用。
通过常见睾丸病变的实例说明现代超声造影（CEUS）的优势。
对有关CEUS在睾丸病变中应用的相关研究进行评估。在PubMed和Medline上筛选综述和临床试验。
在鉴别睾丸良性和恶性病变时，造影剂摄取，例如可以排除出血性睾丸囊肿。目前无法仅通过单纯的增强来区分睾丸良性和恶性病变。睾丸脓肿、梗死和感染的评估取决于对血管化的评估。阴囊外伤后，增强评估可区分存活和非存活区域。完全无灌注可能支持睾丸扭转的诊断。
CEUS是睾丸病变诊断检查中的一种可行手段。先前研究的结果很有前景。关于在阴囊外伤病例中的应用，该方法在未来可能发挥重要作用。关于不明睾丸病变的分类，需要更多患者的进一步研究以证实先前描述的灌注模式。
