高频彩色多普勒超声诊断睾丸结核32例分析

摘要

目的:分析睾丸结核的彩色多普勒超声声像图特征并探讨其临床应用价值.方法:收集经高频彩色多普勒超声检查并且经手术及病理证实的睾丸结核患者32例,对其二维声像图及彩色血流信号特征进行回顾性分析.结果:①睾丸声像图主要表现为病变侧睾丸内实性不均质回声,彩色多普勒血流成像(CDFI)显示为星点状血流信号或无明星血流信号.根据表现基本可分为弥漫结节型(19例,占59.4%)、肿块型(3例,占9.4%)、脓肿型(5例,占15.6%)以及窦道型(5例,占15.6%).②71.9%(23/32)病例合并同侧附睾结核,28.1%(9/32)仅睾丸本身发病,提示睾丸结核主要系直接蔓延而来.③术前超声诊断的符合率93.8%(30/32),误诊率6.2%(2/32).结论:高频彩色多普勒超声能够显示不同类型睾丸结核声像图及血流信号特点,在其临床诊断及鉴别诊断中具有重要的应用价值.%Objective:To observe the properties of tuberculocele on color Doppler ultrasonography and assess the diagnostic value in clinic application.Methods: Retrospective analysis was performed in 32 cases with cuberculocele confirmed by both surgery and pathology.All patients underwent high-frequency ultrasonograpy,and characteristics on 2-dimensional ultrasonogram and color Doppler flow signal were analyzed.Results: Tuberculocele on the ultrasonogram was characterized by heterogeneous echo texture at the lesion side and star-like blood flow signal or absence of typical blood flow signal on color Doppler flow imaging(CDFI).By the ultrasonographic performance,tuberculocele consisted of diffuse nodule type(n=19,59.4%),mass type(n=3,9.4%),abscess type(n=5,15.6%) and fistula type(n=5,15.6%).71.9% cases(23/32) were tuberculosis of the ipsilateral epididymis,and 28.1%(9/32) were primary tuberculocele developed from the epididymis.The accuracy rate was 93.8%(30/32),and misdiagnosis was 6.2%(2/32) by pre-operative ultransonography.Conclusion: High-frequency color Doppler ultrasound can be differential role and diagnostic value in the diagnosis of tuberculocele,because it can display different types of ultrasonogram and blood signal for this disease.