Song Sang Hoon, Afşarlar Çağatay E, Xie Hui Wen, Hung Andrew J, Koh Chester J
Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, USA.
Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
Ultrasonography. 2020 Apr;39(2):152-158. doi: 10.14366/usg.19055. Epub 2020 Jan 4.
We aimed to document the time of onset of ultrasonographic and histologic changes in the testes of a rat model following testicular torsion.
Twenty-five Sprague-Dawley rats were divided into four groups. All animals underwent preoperative Doppler ultrasonography. Groups 1, 2, and 3 underwent unilateral surgical torsion of the testis lasting for 72, 24, and 6 hours, respectively. Group 4 underwent a sham operation. The animals were followed with Doppler ultrasonography at 6, 24, 48, and 72 hours postoperatively. Histologic examinations were performed at the designated final time point for each group.
After torsion, enlargement of the epididymal head and thickening of the spermatic cord over time were noted. Based on the ultrasonographic dimensions, the ratio of the epididymal volume increased with time following torsion (p=0.002). The torsed testes had an average weight gain of 0.27 g at 6 hours compared to the control testes, but an average weight loss of 0.22 g at 72 hours (P=0.006). Changes in testicular echotexture were noted as soon as 6 hours after torsion, but there was no consistent pattern of echotexture change thereafter. Histologically, viable tubules were seen 6 hours after torsion, while extensive hemorrhagic necrosis was found at 72 hours.
In evaluating testicular torsion, the enlargement ratio of the epididymis and thickening of the spermatic cord on Doppler ultrasonography may be useful for determining the urgency of immediate surgery. Changes in testicular echotexture may not be a reliable indicator of the time of onset.
我们旨在记录睾丸扭转大鼠模型中睾丸超声和组织学变化的起始时间。
25只Sprague-Dawley大鼠分为四组。所有动物术前行多普勒超声检查。第1、2和3组分别进行单侧睾丸手术扭转，持续72小时、24小时和6小时。第4组进行假手术。术后6小时、24小时、48小时和72小时对动物进行多普勒超声随访。在每组指定的最终时间点进行组织学检查。
扭转后，随着时间推移，附睾头部增大，精索增粗。根据超声测量尺寸，扭转后附睾体积比随时间增加（p = 0.002）。扭转的睾丸在6小时时平均重量比对照睾丸增加0.27 g，但在72小时时平均重量减轻0.22 g（P = 0.006）。扭转后6小时即可观察到睾丸回声纹理变化，但此后回声纹理变化无一致模式。组织学上，扭转后6小时可见存活的曲细精管，而在72小时发现广泛的出血性坏死。
在评估睾丸扭转时，多普勒超声检查显示的附睾增大率和精索增粗可能有助于确定立即手术的紧迫性。睾丸回声纹理变化可能不是起始时间的可靠指标。
