Chung J J, Kim M J, Lee T, Yoo H S, Lee J T
Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.
J Clin Ultrasound. 1997 Sep;25(7):390-4. doi: 10.1002/(sici)1097-0096(199709)25:7<390::aid-jcu7>3.0.co;2-5.
This paper presents the sonographic findings in scrotums of patients affected with tuberculous epididymitis or epididymo-orchitis.
Eighteen patients with a total of 22 abnormal hemiscrotums (4 patients had bilateral lesions) underwent scrotal sonography. Pathologic confirmation was obtained via epididymectomy in 10 cases, epididymo-orchiectomy in 7 cases, and scrotal exploration and biopsy in 3 cases. The histopathologic diagnosis was tuberculous epididymitis in 12 cases and epididymo-orchitis in 8 cases.
Lesions involved the head of the epididymis in 8 cases, the tail in 5 cases, and the entire epididymis in 9 cases. The enlarged epididymis was hypoechoic in 13 cases, hyperechoic in 2 cases, and of mixed echogenicity in 7 cases. The echotexture was heterogeneous in 17 cases and homogeneous in 5 cases. Testicular involvement in 7 cases appeared as a diffusely enlarged hypoechoic testis in 2 cases, an ill-defined hypoechoic lesion in 1 case, a well-demarcated hypoechoic lesion in 2 cases, and multiple small hypoechoic nodules in an enlarged testis in 2 cases. Hydrocele, sinus tract, and extratesticular calcifications were seen in 12, 4, and 2 cases, respectively.
The heterogeneous and hypoechoic swelling of the epididymis or the concomitant hypoechoic lesion of the testis with associated sinus tract or extratesticular calcifications may be helpful in the diagnosis of tuberculous epididymitis or epididymo-orchitis, especially in patients with known genitourinary tuberculosis.
本文介绍了患结核性附睾炎或附睾睾丸炎患者阴囊的超声检查结果。
18例患者共22个患侧阴囊异常（4例为双侧病变）接受了阴囊超声检查。10例行附睾切除术、7例行附睾睾丸切除术、3例行阴囊探查及活检以获得病理证实。组织病理学诊断为结核性附睾炎12例，附睾睾丸炎8例。
病变累及附睾头部8例，尾部5例，整个附睾9例。肿大的附睾呈低回声13例，高回声2例，混合回声7例。回声纹理不均匀17例，均匀5例。7例睾丸受累表现为：2例睾丸弥漫性肿大呈低回声，1例低回声病变边界不清，2例低回声病变边界清晰，2例肿大睾丸内见多个小低回声结节。分别有12例、4例和2例出现鞘膜积液、窦道和睾丸外钙化。
附睾不均匀低回声肿胀或睾丸伴发低回声病变及相关窦道或睾丸外钙化可能有助于结核性附睾炎或附睾睾丸炎的诊断，尤其是在已知泌尿生殖系统结核的患者中。
