Ban Yongguang, Lan Di, Wang Shanshan, Liu Wei, Fu Xiaoqing, Hou Li, Guo Lingfei, Teng Jianbo, Luan Qinhua
Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Department of Radiology, Qingdao Municipal Hospital, Qingdao, China.
Quant Imaging Med Surg. 2024 Aug 1;14(8):5434-5442. doi: 10.21037/qims-24-288. Epub 2024 Jul 16.
Extravaginal testicular torsion has profound clinical implications in neonates, but its ultrasound characteristics may vary at different disease stages. The purpose of this study was to identify the ultrasound characteristics of neonatal extravaginal testicular torsion and their diagnostic value at different disease stages.
A retrospective analysis of the clinical and ultrasound examination data of 20 infants aged 1-75 days with surgically and pathologically confirmed unilateral extravaginal testicular torsion (10 right, 10 left) was conducted. The infants were divided into three stages based on the ultrasound characteristics: double-ring effusion, calcification of the tunica vaginalis, and testicular atrophy.
In the double-ring effusion stage, the affected testicles were enlarged with axial abnormalities, with the parenchymal testicular blood flow signal significantly reduced or absent. Twisted paratesticular masses and a "double-ring effusion sign" were visible. In the tunica vaginalis calcification stage, the affected testicles were slightly smaller, with axial abnormalities, absent blood flow signals in the testicular parenchyma, and strong echogenicity of the tunica vaginalis. In the testicular atrophy stage, the affected testicles were markedly smaller, with enhanced echogenicity in the tunica vaginalis and parenchyma, and absent blood flow signal in the testicular parenchyma. The volumes of the affected testicles gradually decreased from the stage of double-ring effusion to that of tunica vaginalis calcification, and then to testicular atrophy (P<0.05).
Neonatal extravaginal testicular torsion at different disease stages has distinct ultrasound features, and color doppler ultrasound plays an important role in the diagnosis and treatment of extravaginal testicular torsion.
新生儿睾丸外扭转具有深远的临床意义，但其超声特征在不同疾病阶段可能有所不同。本研究的目的是确定新生儿睾丸外扭转的超声特征及其在不同疾病阶段的诊断价值。
对20例年龄在1至75天、经手术和病理证实为单侧睾丸外扭转（10例右侧，10例左侧）的婴儿的临床和超声检查数据进行回顾性分析。根据超声特征将婴儿分为三个阶段：双环积液、鞘膜钙化和睾丸萎缩。
在双环积液阶段，患侧睾丸增大，轴向异常，睾丸实质血流信号明显减少或消失。可见扭转的睾丸旁肿块和“双环积液征”。在鞘膜钙化阶段，患侧睾丸略小，轴向异常，睾丸实质无血流信号，鞘膜呈强回声。在睾丸萎缩阶段，患侧睾丸明显变小，鞘膜和实质回声增强，睾丸实质无血流信号。患侧睾丸体积从双环积液阶段到鞘膜钙化阶段再到睾丸萎缩阶段逐渐减小（P<0.05）。
不同疾病阶段的新生儿睾丸外扭转具有明显的超声特征，彩色多普勒超声在睾丸外扭转的诊断和治疗中起重要作用。
