海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2015年
15期
2253-2256
,共4页
张胜林%陈英银%陈声亮%刘翠玲%熊涛%谢许萍
張勝林%陳英銀%陳聲亮%劉翠玲%熊濤%謝許萍
장성림%진영은%진성량%류취령%웅도%사허평
彩色多普勒超声%青少年%阴囊急症%价值
綵色多普勒超聲%青少年%陰囊急癥%價值
채색다보륵초성%청소년%음낭급증%개치
Color Doppler ultrasonography%Adolescents%Acute scrotum%Value
目的：探讨彩色多普勒超声在青少年阴囊急症中的应用价值。方法回顾性分析我院2013年1月至2014年10月收治的48例青少年阴囊急症患者的临床资料，经手术、药物及临床症状确诊为睾丸扭转13例、附睾炎16例、睾丸炎7例、睾丸外伤12例，所有患者均进行多普勒超声检查，比较4种不同类型阴囊急症的血流信号、超声图像特点及诊断结果。结果附睾炎组和睾丸炎组患者的收缩期最大血流速度(Vmax)均明显高于睾丸扭转组和睾丸外伤组患者，附睾炎组和睾丸炎组患者的血流阻力指数(RI)明显低于睾丸扭转和睾丸外伤组，睾丸外伤组患者的Vmax明显高于睾丸扭转组，RI明显低于睾丸扭转组，以上各项指标两两比较差异均具有统计学意义(P<0.05)；超声诊断睾丸扭转的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为92.3%、97.1%、89.4%、92.3%、97.1%，附睾炎分别为92.3%、88.6%、80.9%、75.0%、96.7%，睾丸炎分别为55.6%、94.7%、50.5%、71.4%、90.2%，睾丸外伤分别为84.6%、97.1%、81.7%、91.7%、94.4%。结论彩色多普勒可有效鉴别睾丸炎症、睾丸外伤及睾丸扭转，但对于附睾炎及睾丸炎仅凭血流信号鉴别诊断较难，应结合患者的临床症状、血流信号、睾丸内部形态学做出判断。
目的：探討綵色多普勒超聲在青少年陰囊急癥中的應用價值。方法迴顧性分析我院2013年1月至2014年10月收治的48例青少年陰囊急癥患者的臨床資料，經手術、藥物及臨床癥狀確診為睪汍扭轉13例、附睪炎16例、睪汍炎7例、睪汍外傷12例，所有患者均進行多普勒超聲檢查，比較4種不同類型陰囊急癥的血流信號、超聲圖像特點及診斷結果。結果附睪炎組和睪汍炎組患者的收縮期最大血流速度(Vmax)均明顯高于睪汍扭轉組和睪汍外傷組患者，附睪炎組和睪汍炎組患者的血流阻力指數(RI)明顯低于睪汍扭轉和睪汍外傷組，睪汍外傷組患者的Vmax明顯高于睪汍扭轉組，RI明顯低于睪汍扭轉組，以上各項指標兩兩比較差異均具有統計學意義(P<0.05)；超聲診斷睪汍扭轉的敏感度、特異度、準確度、暘性預測值、陰性預測值分彆為92.3%、97.1%、89.4%、92.3%、97.1%，附睪炎分彆為92.3%、88.6%、80.9%、75.0%、96.7%，睪汍炎分彆為55.6%、94.7%、50.5%、71.4%、90.2%，睪汍外傷分彆為84.6%、97.1%、81.7%、91.7%、94.4%。結論綵色多普勒可有效鑒彆睪汍炎癥、睪汍外傷及睪汍扭轉，但對于附睪炎及睪汍炎僅憑血流信號鑒彆診斷較難，應結閤患者的臨床癥狀、血流信號、睪汍內部形態學做齣判斷。
목적：탐토채색다보륵초성재청소년음낭급증중적응용개치。방법회고성분석아원2013년1월지2014년10월수치적48례청소년음낭급증환자적림상자료，경수술、약물급림상증상학진위고환뉴전13례、부고염16례、고환염7례、고환외상12례，소유환자균진행다보륵초성검사，비교4충불동류형음낭급증적혈류신호、초성도상특점급진단결과。결과부고염조화고환염조환자적수축기최대혈류속도(Vmax)균명현고우고환뉴전조화고환외상조환자，부고염조화고환염조환자적혈류조력지수(RI)명현저우고환뉴전화고환외상조，고환외상조환자적Vmax명현고우고환뉴전조，RI명현저우고환뉴전조，이상각항지표량량비교차이균구유통계학의의(P<0.05)；초성진단고환뉴전적민감도、특이도、준학도、양성예측치、음성예측치분별위92.3%、97.1%、89.4%、92.3%、97.1%，부고염분별위92.3%、88.6%、80.9%、75.0%、96.7%，고환염분별위55.6%、94.7%、50.5%、71.4%、90.2%，고환외상분별위84.6%、97.1%、81.7%、91.7%、94.4%。결론채색다보륵가유효감별고환염증、고환외상급고환뉴전，단대우부고염급고환염부빙혈류신호감별진단교난，응결합환자적림상증상、혈류신호、고환내부형태학주출판단。
Objective To explore the application value of color Doppler ultrasonography in adolescents with acute scrotum. Methods The clinical data of 48 adolescents with acute scrotum from January 2013 to October 2014 were retrospectively analyzed, including 13 cases of testicular torsion (testicular torsion group), 16 cases of epididymi-tis (epididymitis group), 7 cases of orchitis (orchitis group), and 12 cases of testicular trauma (testicular trauma group). All patients underwent color Doppler ultrasonography. Blood flow signals, characteristics of ultrasound imag-es and diagnosis results of the four types of acute scrotum were compared. Results The peak systolic velocity (Vmax) was significantly higher in the epididymitis group and orchitis group than the testicular torsion group and testicular trauma group. The vascular resistance index (RI) was significantly lower in the epididymitis group and orchitis group than thetesticular torsion group and testicular trauma group. The Vmax in the testicular trauma group was significantly higher than that in the testicular torsion group. The RI in the testicular trauma group was significantly lower than that in the testicular torsion group. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of ultrasound diagnosis were 92.3%, 97.1%, 89.4%, 92.3%, 97.1% for testicular torsion, 92.3%, 88.6%, 80.9%, 75.0%, 96.7% for epididymitis, 55.6%, 94.7%, 50.5%, 71.4%, 90.2% for orchitis, 84.6%, 97.1%, 81.7%, 91.7%, 94.4%for testicular trauma. Conclusion Color Doppler ultrasonography is useful to identify testicular inflammation, testicular trauma, and testicular torsion. However, it is difficult to identify epididymitis and orchitis only according to blood flow signals, and the diagnosis should be based on clinical symptoms, blood flow, and internal morphology.
