目的 分析睾丸非肿瘤性病变的超声与CT诊断价值。方法 回顾性分析58例经临床病史、超声、CT或病理证实的睾丸非肿瘤性病例,结合临床病史,分析其超声与CT表现,包括炎性(或感染性)病变、外伤性病变、先天性病变及扭转急症。结果 所有病例均行CT检查,睾丸炎症性病变共39例(包括一般性炎症,脓肿和结核),其中19例行超声检查;睾丸外伤8例,隐睾9例,睾丸扭转2例,均行超声检查。睾丸炎症性病变临床表现为患侧或双侧阴囊不同程度的红、肿、痛,或白细胞升高、其他脏器伴发结核,超声表现为睾丸体积不同程度增大,根据炎症坏死程度不同,回声表现为回声均质、回声减低、回声不均质,坏死灶内无血流信号;CT表现为睾丸体积增大,根据炎症性病变的不同可表现为睾丸轻度强化、环形强化,可伴有睾丸鞘膜积液、点状钙化或积气;睾丸外伤均有阴囊外伤史,根据受伤程度表现为白膜下血肿、实质出血、睾丸破裂;隐睾表现为睾丸位置异常或缺如;睾丸扭转表现为睾丸短时间内剧烈疼痛,并进行性加重,超声表现为“镯环征”,CT表现为精索扭转、水肿,睾丸实质水肿。结论 睾丸非肿瘤性病变超声与CT征象均具有特征性,结合患者病史可作出准确诊断。超声检查较为便捷,CT检查可免除受检者接触性疼痛、可对盆腔及腹腔进行更为全面的观察。

Objective: Discussion on diagnosis of testicular non-tumorous lesions by ultrasound and CT.Methods: Rretrospective analysis of 58 testicular non-tumor cases proved by clinical history, Ultrasound, CT or pathologically,combined with the clinical history, and analysis of the Ultrasound and CT features,including inflammatory or infectious disease, traumatic disease, congenital disease and acute torsion.Results: All cases were examined by CT,the testicular inflammatory lesions were 39 cases, 19 of them were examined by ultrasound; testicular trauma 8 cases,cryptorchidism 9 cases, testicular torsion in 2 cases, all of them were examined by ultrasound. The clinical symptom of the inflammatory lesions of the ipsilateral or bilateral scrotum with different degrees of red, swollen, painful, or leukocytosis, other organs associated with TB, Ultrasound showed the testicular volume increased to varying degrees,according to the degree of inflammation and necrosis, the echo showed homogeneous echo, echo reduction, echo heterogeneity, and no blood flow signal in the necrotic area.CT showed an increase in testicular volume, according to the different inflammatory lesions showed mild enhancement of testis, ring enhancement, with a hydrocele, calcification or gas; testicular trauma had scrotal trauma history, according to the severity of injury showed subcapsular hematoma, hemorrhage and rupture of testis; testicular cryptorchidism showed abnormal position or absent; testicular torsion showed testicular short time severe pain, and progressive, Ultrasound showed “bracelet ring sign”, CT showed testicular torsion, edema, testicular parenchyma edema.Conclusion: Ultrasound and CT features of testicular non-tumorous lesions are characteristic, and the accurate diagnosis can be made with the combination of the patient's clinical history. Ultrasound examination is more convenient, CT examination can relieve the patient's contact pain, can be more comprehensive observation of the pelvic and abdominal.

目的 探讨彩色多普勒超声在无精子症患者睾丸穿刺活检中的应用价值。方法 回顾性分析2012年11月—2015年2月在我科诊断为无精子症的53例患者的病例资料。所有患者进行常规阴囊超声检查,采用频谱多普勒检测睾丸动脉(TA)、睾丸内动脉(ITA)的收缩期最大速度(PSV)、舒张末期速度(EDV)和阻力指数(RI)。采用彩色多普勒超声观察睾丸内的血管分布及其数目,并进行半定量评分。所有患者进行睾丸穿刺活检并进行Johnsen评分。结果 47例患者诊断为梗阻性无精子症(OA),6例患者诊断为非梗阻性无精子症(NOA)。0A组睾丸的平均体积(15.3±3.6) mL,NOA组睾丸的平均体积(7.1±2.8) mL,差异有统计学意义(P＜0.01);OA组与NOA组患者睾丸的血流参数(PSV、EDV、RI) 结果有统计学意义(P＜0.05);OA组与NOA组睾丸内血管半定量分级有的差异,其差异有统计学意义(P＜0.01)。结论 彩色多普勒超声检查对睾丸生精功能有很好的预测作用,可作为鉴别OA患者和NOA患者的指标。

Objective To explore the application value of color Doppler ultrasound in patients with azoospermia who underwent testicular needle biopsy. Methods Retrospective analysed the clinical data of 53 cases patients with azoospermia from 2012 November to 2015 February in our department.All patients underwent routine scrotal ultrasonography, to detecte the peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of testicular artery (TA)and intratesticular artery (ITA)with spectral Doppler ultrasound. Color Doppler ultrasound was used to observe the distribution and the number of blood vessels in the testicle, and semi quantitative score. All patients underwent testicular biopsy and Johnsen score. Results 47 patients were diagnosed as obstructive azoospermia(OA), 6 patients were diagnosed as non obstructive azoospermia(NOA). The average volume of testis was (15.3±3.6)mL in 0A group. The average volume of testis was (7.1±2.8) mL in N0A group.There was significant difference (P<0.01). The blood flow parameters(PSV, EDV, RI) results between OA group and NOA group have obvious difference,the difference was statistically significant (P<0.05). The semi quantitative classification of testicular vessels between OA group and NOA group have obvious difference,the difference was statistically significant (P< 0.01). Conclusion Color Doppler ultrasound is a good predictor of testicular spermatogenic function, can be used as the identification index of patients with OA and patients with NOA.

目的 探讨微泡增强的超声空化增加睾丸组织的药物浓度的可行性。方法 18只雄性8月龄性成熟新西兰兔随机分为空白对照组(C)、单纯微泡组(MB)、治疗超声组(TUS)、超声联合微泡辐照组(MEUS)4组,每组各9个。MB组给予静注微泡造影剂 0.1 mL/kg ;TUS组给予超声辐照5min;MEUS组给予静注微泡造影剂0.1 mL/kg的同时超声辐照5min;每组在治疗前5min均经耳缘静脉注射2%伊文思蓝(EB)2.5 mL/kg;治疗后1 h取各组睾丸组织制备组织匀浆测量 EB 浓度。结果 MEUS组兔睾丸组织内 EB 浓度高于其他各组(P<0.05),差异有统计学意义。结论 微泡增强的超声空化可以明显提高睾丸组织内EB浓度。

Objective To investigate feasibility of microbubbles enhanced ultrasound (MEUS) on the concentration of Evans blue (EB) in rabbit,stestis. Methods Eighteen sexually mature male New Zealand rabbits were divided into four groups randomly. Pulsed ultrasound irradiation and intravenous microbubbles injection were both applied in the microbubbles enhanced ultrasound group (MEUS), pulsed ultrasound irradiation and intravenous microbubbles injection were individually applied in the therapeutic ultrasound group (TUS) and the simple microbubbles group (MB). Injection of EB was applied in each group five minutes before the treatment.Concentration of EB in testis tissue was measured homogenated. Results The concentration of Evans blue(EB) in rabbit's testis in MEUS group was statistically higher than the other groups (P<0.05). Conclusion Microbubbles enhanced ultrasound (MEUS) can increase the concentration of Evans blue (EB) in rabbit's testis.