Middleton W D, Middleton M A, Dierks M, Keetch D, Dierks S
Mallinckrodt Institute of Radiology, St. Louis, MO 63110, USA.
J Ultrasound Med. 1997 Jan;16(1):23-7; quiz 29-30. doi: 10.7863/jum.1997.16.1.23.
This study was performed to determine if sonography can assist in predicting testicular viability in the setting of testicular torsion. Sixteen patients with sonographically diagnosed and surgically proved testicular torsion were studied. The preoperative sonograms were reviewed retrospectively to determine testicular echogenicity and homogeneity, testicular size and vascularity, scrotal skin thickness and vascularity, and the presence or absence of a hydrocele. These findings were correlated with the viability of the testis at surgery. All nine patients with normal homogeneous testicular echogenicity had viable testes at surgery. All seven patients with hypoechoic or inhomogeneous testes had nonviable testes at surgery and pathologic evidence of necrosis. The other findings were less helpful in predicting viability. In the setting of testicular torsion, normal testicular echogenicity is a strong predictor of viability. Immediate surgical detorsion in these patients carries a very high likelihood of salvaging the affected testis.
本研究旨在确定超声检查能否在睾丸扭转情况下辅助预测睾丸的存活能力。对16例经超声诊断并经手术证实为睾丸扭转的患者进行了研究。回顾性分析术前超声图像，以确定睾丸的回声性和均匀性、睾丸大小和血管情况、阴囊皮肤厚度和血管情况以及鞘膜积液的有无。将这些发现与手术时睾丸的存活能力进行关联。所有9例睾丸回声均匀正常的患者在手术时睾丸均存活。所有7例睾丸回声低或不均匀的患者在手术时睾丸均无存活能力且有坏死的病理证据。其他发现对预测存活能力的帮助较小。在睾丸扭转情况下，正常的睾丸回声性是存活能力的有力预测指标。对这些患者立即进行手术复位扭转，挽救患侧睾丸的可能性非常高。
