Zhou Wei, Li Shoulin, Wang Hao, Yin Jianchun, Liu Xiaodong, Jiang Junhai, Zhou Guanglun, Wen Jianguo
Pediatric Urodynamic Centre, Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Shenzhen, China.
Front Pediatr. 2022 Aug 18;10:914139. doi: 10.3389/fped.2022.914139. eCollection 2022.
The study aimed to investigate the diagnostic value of ultrasound in children's transverse testicular ectopia (TTE).
We retrospectively studies all TTE cases diagnosed in our hospital from January 2017 to December 2021. All cases were evaluated by ultrasound examination and compared to physical examination and diagnostic laparoscopy results.
This study included 14 TTE patients in total, with a median age was 1.08 years. In the 14 TTE, physical examination found 10 TTE cases, of which nine testes were located in the opposite scrotum, one testis was located in the opposite groin, and the other four testes were not observed by physical examination. All cases were diagnosed by preoperative ultrasound, and nine testes were located in the opposite scrotum, two testes were located in the opposite groin, and three testes were located next to the opposite iliac vessel in the abdominal cavity. Preoperative ultrasound showed the ectopic spermatic cord in six cases (6/14, 42.8%) and persistent Müllerian duct syndrome (PMDS) in one case (1/14, 7%). Diagnostic laparoscopy finally confirmed 14 cases of TTE, which was consistent with preoperative ultrasound, and the coincidence rate was 100% (14/14). Among the 14 cases of TTE, diagnostic laparoscopy showed that 12 cases had ectopic spermatic vessels and vas deferens (12/14, 85.7%), and six cases were associated with PMDS (6/14, 42.8%). When TTE was associated with the ectopic spermatic cord and PMDS, the diagnostic performance of diagnostic laparoscopy was better than that of preoperative ultrasound ( < 0.05). The testis volume of the affected side of TTE was less than that of the contralateral testis ( < 0.05).
Ultrasonography is very helpful for the preoperative diagnosis of TTE in children, and it is suitable as a non-surgical method for locating ectopictestis. Preoperative assessment of the exact presence of PMDS is difficult and unclear. This may be related to factors such as pelvic developmental stages in infancy, examination techniques, and atypical imaging findings of PMDS.
本研究旨在探讨超声对儿童睾丸横过异位（TTE）的诊断价值。
我们回顾性研究了2017年1月至2021年12月在我院诊断的所有TTE病例。所有病例均通过超声检查进行评估，并与体格检查和诊断性腹腔镜检查结果进行比较。
本研究共纳入14例TTE患者，中位年龄为1.08岁。在这14例TTE中，体格检查发现10例，其中9个睾丸位于对侧阴囊，1个睾丸位于对侧腹股沟，另外4个睾丸未通过体格检查发现。所有病例术前超声均诊断明确，9个睾丸位于对侧阴囊，2个睾丸位于对侧腹股沟，3个睾丸位于腹腔内对侧髂血管旁。术前超声显示6例（6/14，42.8%）存在异位精索，1例（该文档此处有误，根据前文逻辑，应为1/14，7%）存在持续性苗勒管综合征（PMDS）。诊断性腹腔镜最终确诊14例TTE，与术前超声结果一致，符合率为100%（14/14）。在14例TTE中，诊断性腹腔镜显示12例存在异位精索血管和输精管（12/14，85.7%），6例合并PMDS（6/14，42.8%）。当TTE合并异位精索和PMDS时，诊断性腹腔镜的诊断性能优于术前超声（P<0.05）。TTE患侧睾丸体积小于对侧睾丸（P<0.05）。
超声对儿童TTE的术前诊断非常有帮助，适合作为定位异位睾丸的非手术方法。术前准确评估PMDS的存在较为困难且不明确。这可能与婴儿期盆腔发育阶段、检查技术以及PMDS的非典型影像学表现等因素有关。
