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中华医学超声杂志(电子版) ›› 2022, Vol. 19 ›› Issue (12) : 1373 -1376. doi: 10.3877/cma.j.issn.1672-6448.2022.12.010

浅表器官超声影像学

睾丸结核的临床与超声影像学特征分析
高琳1, 张一休1,(), 杨筱1, 德央1, 宋彬彬2, 王元胜2, 格桑德吉2, 尼玛玉珍2   
  1. 1. 100730 中国医学科学院 北京协和医学院 北京协和医院 协和转化医学中心 超声医学科;850000 西藏自治区人民医院超声科
    2. 850000 西藏自治区人民医院超声科
  • 收稿日期:2021-05-12 出版日期:2022-12-01
  • 通信作者: 张一休
  • 基金资助:
    国家自然科学基金(81901745)

Clinical and sonographic features of testicular tuberculosis

Lin Gao1, Yixiu Zhang1,(), Xiao Yang1, yang De1, Binbin Song2, Yuansheng Wang2, Gesangdeji2, Nimayuzhen2   

  1. 1. Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; Department of Ultrasound, Tibet Autonomous Region People's Hospital, Lhasa 850000, China
    2. Department of Ultrasound, Tibet Autonomous Region People's Hospital, Lhasa 850000, China
  • Received:2021-05-12 Published:2022-12-01
  • Corresponding author: Yixiu Zhang
引用本文:

高琳, 张一休, 杨筱, 德央, 宋彬彬, 王元胜, 格桑德吉, 尼玛玉珍. 睾丸结核的临床与超声影像学特征分析[J/OL]. 中华医学超声杂志(电子版), 2022, 19(12): 1373-1376.

Lin Gao, Yixiu Zhang, Xiao Yang, yang De, Binbin Song, Yuansheng Wang, Gesangdeji, Nimayuzhen. Clinical and sonographic features of testicular tuberculosis[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(12): 1373-1376.

目的

探讨睾丸结核的临床及超声影像学特征。

方法

回顾性分析2013年1月至2020年10月西藏自治区人民医院37例临床诊断为睾丸结核的患者的临床及超声影像学资料,总结其特征。

结果

37例患者中单侧睾丸结核26例,双侧睾丸结核11例。临床症状以阴囊肿大、慢性肿胀疼痛为主。超声检查表现多样,以片状低回声及混合回声(17/37,45.9%)、粟粒样结节(18/37,48.6%)、结节或肿块(6/37,16.2%)、窦道形成(8/37,21.62%)为主要超声表现,部分患者可多种征象并存。32例患者同时伴发附睾结核声像图改变,表现为附睾弥漫性增大、结节或脓肿。

结论

睾丸结核的临床表现及超声声像图表现多样。详细了解相关病史,熟练掌握其超声声像图特征及鉴别诊断要点,有助于做出正确诊断。

Objective

To investigate the clinical and ultrasonographic features of testicular tuberculosis.

Methods

Thirty-seven patients clinically diagnosed with testicular tuberculosis at Tibet Autonomous Region People's Hospital from January 2013 to October 2020 were reviewed retrospectively, and the clinical and sonographic imaging characteristics were summarized.

Results

Among the 37 cases included, 26 were unilateral testicular tuberculosis and 11 were bilateral. The main clinical symptoms were scrotal enlargement, chronic swelling, and pain. The ultrasonographic findings of testicular tuberculosis were diverse and nonspecific, mainly including patchy hypoechoic and mixed echo (17/37, 45.9%), miliary nodules (18/37, 48.6%), nodule or mass (6/37, 16.2%), and sinus formation (8/37, 21.62%). Some patients could have multiple signs. Thirty-two patients were accompanied with epididymal tuberculosis, which showed diffuse enlargement, nodules, or abscesses.

Conclusion

The clinical and ultrasonic manifestations of testicular tuberculosis are diverse. A detailed understanding of relevant medical history, the ultrasonic image characteristics, and the key points of differential diagnosis will help to make a correct diagnosis.

图1 患者,男性,35岁,睾丸附睾结核超声图像。图a为睾丸纵切面示睾丸结构僵硬,包膜不清晰,内可见片状低回声(箭头所示),边界不清,可见附睾肿大,回声减低;图b为睾丸横切面彩色多普勒示低回声内(箭头所示)可见条状血流信号;图c为睾丸纵切面示睾丸内另可见多发散在细小低回声结节(箭头所示),直径<0.5 cm;图d为睾丸纵切面彩色多普勒示部分细小低回声内可见少许散在血流信号;图e为睾丸旁矢状切面示可见窦道形成(箭头所示);图f为睾丸、附睾纵切面彩色多普勒示附睾尾部可见液性暗区,透声较差,脓肿形成(箭头所示)注:EH为附睾头;EB为附睾体;ET为附睾尾
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