Komatsu Shugo, Terui Keita, Takenouchi Ayako, Kawaguchi Yunosuke, Nishimura Katsuhiro, Oita Satoru, Yoshizawa Hiroko, Takiguchi Shota, Hishiki Tomoro
Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan.
Surg Today. 2025 Mar;55(3):386-392. doi: 10.1007/s00595-024-02908-9. Epub 2024 Jul 31.
This pilot study evaluated indocyanine green-guided near-infrared fluorescence (ICG-NIRF) imaging of testicular blood flow to predict long-term testicular atrophy after testicular torsion (TT) surgery.
The subjects of this retrospective study were patients who underwent surgery for TT at our hospital between December, 2020 and July, 2022. After detorsion, testicular blood flow was evaluated by ICG-NIRF imaging and classified into three categories: fluorescence detected, no fluorescence detected, and fluorescence detected only in the tunica albuginea vessels. Testicular volume was measured by ultrasonography up to 12 months after surgery to evaluate long-term outcomes.
Twelve patients were included in this analysis. We found a 100% correlation between the absence of ICG-NIRF signals and subsequent testicular atrophy. In three patients without an ICG-NIRF signal, the median testis size 12 months postoperatively was significantly smaller (16.5% of the contralateral testis; range 13-20%) than that in six patients with an ICG-NIRF signal (96%; 89-115%) (p = 0.013). Mild atrophy (74.5%; 73-76%) was also observed in the three patients for whom an ICG-NIRF signal was detected only in the tunica albuginea vessels.
Our pilot study highlights the potential of ICG-NIRF imaging as a prognostic tool for guiding surgical decision-making for patients with TT, by predicting postoperative testicular atrophy.
本前瞻性研究评估了吲哚菁绿引导的近红外荧光（ICG-NIRF）成像技术对睾丸扭转（TT）手术后睾丸血流的评估，以预测长期睾丸萎缩情况。
本回顾性研究的对象为2020年12月至2022年7月期间在我院接受TT手术的患者。复位后，通过ICG-NIRF成像评估睾丸血流，并分为三类：检测到荧光、未检测到荧光以及仅在白膜血管中检测到荧光。术后长达12个月通过超声测量睾丸体积，以评估长期预后。
本分析纳入了12例患者。我们发现ICG-NIRF信号缺失与随后的睾丸萎缩之间存在100%的相关性。在3例无ICG-NIRF信号的患者中，术后12个月时睾丸中位大小明显小于6例有ICG-NIRF信号患者的睾丸中位大小（分别为对侧睾丸的16.5%；范围13 - 20%与96%；89 - 115%）（p = 0.013）。在3例仅在白膜血管中检测到ICG-NIRF信号的患者中也观察到轻度萎缩（74.5%；73 - 76%）。
我们的前瞻性研究强调了ICG-NIRF成像作为一种预后工具的潜力，通过预测术后睾丸萎缩来指导TT患者的手术决策。
