超声及临床特征对附睾局灶性病变的鉴别价值

目的:评价超声及临床特征在附睾局灶性病变鉴别诊断中的应用价值。方法:回顾性分析附睾局灶性病变48例,包括非特异性附睾炎、附睾结核和附睾精液囊肿。分析附睾局灶性病变大小、形态、位置、回声强度及均一性,鞘膜腔是否有积液;病灶血流的程度以及患者年龄、病程和阴囊压痛程度。结果:附睾结核病灶平均面积比非特异性附睾炎病灶大(P<0.05),并多可见钙化斑。非特异性附睾炎病灶的血流信号比附睾结核(P<0.05)及附睾精液囊肿(P<0.01)丰富;非特异性附睾炎病程比附睾结核(P<0.01)和附睾精液囊肿(P<0.01)短;非特异性附睾炎病灶的压痛比附睾结核(P<0.01)和附睾精液囊肿(P<0.01)明显。附睾局灶性病变发生位置及有无鞘膜积液无明显区别(P>0.05)。结论:超声和临床特征对附睾局灶性病变鉴别诊断具有重要的价值,为临床诊断、治疗附睾疾病及评价疗效提供客观依据。

The Value of Ultrasonic and Clinical Features in Differential Diagnosis of Focal Epididymal Lesions

Objective: To evaluate the clinical value of ultrasonic and clinical features in differential diagnosis of focal epididymal lesions.Methods: This was a retrospective analysis of 48 focal epididymal lesions including nonspecific epidi-(dymitis,)tuberculous epididymitis and epididymal seminal cysts.The following ultrasonic and clinical features were analyzed:size,location,echogenicity,and heterogeneity of the lesion;presence or absence of hydrocele,blood flow in the lesion;(patient's) age;duration of symptoms;and scrotal tenderness.Results:Focal Lesions of tuberculous epididymitis were larger than the lesions of nonspecific epididymitis(P<0.05) and there was calcified plaques in the lesions of tuberculous epidi-(dymitis.)The blood flow in the lesions of nonspecific epididymitis was more rich than that of tuberculous epididymitis(P<(0.05)) and that of epididymal seminal cysts(P<0.01).The duration of symptoms of tuberculous epidydimitis and epidi-(dymal) seminal cyst was longer than that of nonspecific epididymitis(P<0.01).The frequency of scrotal tenderness was higher in patients with nonspecific epididymitis than that of tuberculous epididymitis(P<0.01) and that of epididymal seminal cysts(P<0.01).There was no manifest difference of focal epididymal lesions in location and presence of hydrocele.Conclusion: Ultrasonic and clinical features have great value in differential diagnosis of focal epididymal lesions and offer objective evidence to clinical diagnosis,treatment of epididymal disease and assessment of curative effect.