附睾及睾丸结核高频超声诊断价值

摘要

Objective To explore the sonographic findings of, differential diagnosis and the diagnostic value in scrotums of patients affected with tuberculous epididymitis or epididymo-orchititis. Methods The tuberculous epididymitis or epididymo-orchititis ultrasonograpy findings ,the outcome of surgery and clinical data in the 21 patients with a total of 24 cases abnormal hemiscrotums( 3 patients with bilateral lesions )were retrospectively analyzed. Pathological confirmation was obtained by epididymectomy in 18 cases and epididymo-orchiectomy in 4 cases. The histopathologic diagnosis was tuberculous epididymitis in 20cases and epididymo-orchitis in 4 cases. Results The lesions were observed in the head of the epididymis in 6 cases, the tails in 11 cases , and the entire epididymis in 7cases were observed. The enlarged epididymis was hypoechoic in 15 cases and mixed echogenicity in 9 cases. Testicular involvement in 4 cases, appeared as a diffusely enlarged hypoechoic testis in 2 cases, an well-demarcated hypoechoic lesion in 1 case,and multiple small hypoechoic nodules in an enlarged testis in 1 case. Hydrocele, sinus tract and scrotum wall abscess were observed in 15 , 2, and 1 cases , respectively.Conclusion The heterogeneous and hypoechoic swelling of the epididymis or the concomitant hypoechoic lesion of the testis with associated sinus tract or scrotum wall nodus were of important value in the diagnosis of tuberculous epididymitis or epididymoorchitis .%目的 探讨附睾及睾丸结核的超声表现、鉴别诊断及其诊断价值.方法 回顾分析21例患者24例侧附睾及睾丸结核的超声表现、手术病理及有关临床资料,其中18例行附睾切除,4例行附睾睾丸切除.术后病理诊断结核性附睾炎20例,结核性附睾-睾丸炎4例.结果 病变位于附睾头部6例,尾部11例,整个附睾受累7例.肿大附睾呈低回声15例,呈混合回声9例.4例睾丸受累,显示为弥漫性肿大呈低回声2例,局部低回声结节1例,增大睾丸内显示粟粒样小低回声结节1例.鞘膜积液、窦道形成、阴囊壁冷脓肿形成分别为15例、2例和1例.结论 超声检查示附睾呈低回声非均质肿大或伴随睾丸低回声,有窦道形成或阴囊壁脓肿形成对诊断结核性附睾炎或附睾-睾丸炎具有重要价值.