彩色多普勒超声预测睾丸扭转后存活力的价值

    The value of color Doppler ultrasound in the predicting of the viability after testicular torsion

    • 摘要: 目的:探讨彩色多普勒超声预测睾丸扭转后存活力的临床价值。方法:对16例睾丸扭转患者彩色多普勒声像及临床资料进行回顾性分析,将术前扭转睾丸不同彩色多普勒声像分为a、b、c、d 4种类型;术中扭转睾丸的不同情况,将其存活力分为A~D级,其中将A~C级存活力睾丸保留,D级存活力睾丸切除;将随访的睾丸存活力分为Ⅰ~Ⅲ级,Ⅰ~Ⅱ级睾丸存活,Ⅲ级睾丸萎缩。结果:16例睾丸扭转中,10例手术复位保留,6例手术切除。手术复位中睾丸存活9例,术前声像为a型3例,b型2例,c型4例;术中睾丸存活力为A级1例,B级3例,C级5例;远期睾丸存活力为Ⅰ级2例,Ⅱ级7例。手术复位组中萎缩1例,术前声像分级为d型,术中睾丸存活力为D级,远期睾丸存活力为Ⅲ级。手术切除6例术前声像为c型1例,d型5例;术中睾丸存活力均为D级。结论:彩色多普勒超声检查睾丸扭转并能够预测复位后睾丸的存活力,为临床手术方案选择提供重要参考依据,是挽救扭转睾丸,提高其存活力的关键。

       

      Abstract: Objective: To explore the value of color Doppler ultrasound in the predicting of the viability after testicular torsion. Methods: The clinical data of color Doppler ultrasound flow imaging in 16 cases with testicular torsion were retrospectively analyzed. The testicular torsion were divided into type a,b,c and d according to the color Doppler ultrasound flow imaging before operation. According to intraoperative testicular torsion,testicular viability was divided into level. A,B,C and D The testis with level A to C viability could be saved,the testis with level D viability could not be saved. The testicular viability during the period of following-up could be divided into grade Ⅰ to Ⅲ,the testis with grade Ⅰ and Ⅱ survived,and grade Ⅲ atrophied. Results: Among 16 cases with testicular torsion,the testis in 10 cases and 6 cases were restored and resected,respectively. Nine cases with restoration survived,their preoperative ultrasonography included type a in 3 cases,type b in 2 cases and type c in 4 cases,their intraoperative testicular activity included level A in 1 case,level B in 3 cases and level C in 5 cases,their forward testicular viability included grade Ⅰin 2 cases and Ⅱ grade in 7 cases. One testis with restoration atrophied,its preoperative ultrasonography,intraoperative testicular activity and forward testicular viability were type d,level D and grade Ⅲ,respectively. Amony 6 cases with testicular resection,the type c and d of preoperative ultrasonography were 1 case and 5 cases,respectively,their intraoperative testicular activity were level D. Conclusions: Color Doppler ultrasound of testicular torsion can predict the testis viability,which provide an important reference for clinical surgery program,and is the key to rescue testicular torsion and improve its viability.

       

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