摘要
目的:探讨实时剪切波弹性成像(SWE)在急性睾丸扭转诊断中的应用价值。方法:30只白兔随机分成对照组(S组)、完全扭转组(C组)和不完全扭转组(U组)并建立相应模型。各组术前、术后均行灰阶及彩色多普勒超声、SWE及超声造影(CEUS)检查,记录睾丸被膜区域、睾丸实质、精索扭转段及扭转下段的弹性模量平均(Emean)值及超声造影参数,实验结束取术侧睾丸行病理检查。结果:术前各组相应部位Emean值差异无统计学意义(P>0.05)。S组术后各时段相应部位Emean值差异无统计学意义(P>0.05)。U组术后睾丸被膜区域Emean值升高比C组明显、迅速,术后4~6 h可出现黄色或红色"硬环征",U组术后各时段Emean值差异、C组术后各时段Emean值差异以及U组与C组之间术后1 h、1.5 h、2 h、2.5 h、3 h、3.5 h的Emean值差异有统计学意义(P<0.05)。U组和C组术后睾丸实质Emean值升高约5 kPa,SWE图像始终呈蓝色。C组术后精索扭转段Emean值升高比U组明显,术后5~6 h可出现大片红色信号,C组术后各时段Emean值差异、U组术后各时段Emean值差异以及C组与U组之间除术后即刻、2 h、3 h外各时段的Emean值差异有统计学意义(P<0.05)。U组和C组术后精索扭转下段Emean值缓慢升高(P<0.05),SWE图像由蓝色变成蓝绿色、绿色。U组CEUS睾丸血流灌注为"慢进慢退",病理示睾丸生精细胞肿胀紊乱,间质水肿,被膜区微血管明显扩张、充血淤血并见大量红细胞漏出。C组CEUS睾丸内未见造影剂充填,病理示睾丸生精细胞肿胀紊乱,间质及被膜区微血管轻度扩张、充血淤血,可见部分红细胞漏出。结论:急性睾丸扭转后SWE图像变化与精索扭转时间、程度相关,以患侧睾丸被膜区域、精索扭转段改变最显著;SWE可获得病灶精准的硬度值,对睾丸扭转的判断有一定临床应用价值。
Objective To investigate the value of real-time shear wave elastography(SWE)in the diagnosis of acute testicular torsion.Methods A total of 30 rabbits were randomly divided into 3 groups including control group(Group S),complete torsion group(Group C)and incomplete torsion group(Group U),and corresponding animal models were built.Rabbits in each group were examined by gray scale and color Doppler ultrasound,SWE and contrast-enhanced ultrasound(CEUS)before and after operation.Mean values of elasticity modulus(Emean)of testicular capsule area,parenehyma testis,spermatic cord torsion section,torsion lower section and contrast-enhanced ultrasound parameters were recorded and then pathological examinations were performed.Results There was no significant difference for Emean values of each group in all parts before operation(P>0.05).There was no significant difference for Emean value of S group at each period after operation(P>0.05).Emean value of postoperative testicular capsule area in U group increased obviously and rapidly compared with C group,yellow or red"hard ring signs"appeared within four to six hours after operation,there was significant difference of Emean value difference at various periods after operation in group U and C,and at 1 h,1.5 h,2 h,2.5 h,3 h and 3.5 h postoperatively between group U and C(P<0.05).Postoperative Emean value of parenchyma testis in group C and U increased about 5 kPa,expression of SWE was consistent blue.Postoperative Emean value of spermatic cord torsion section in group C increased more obviously compared with U group,a large patch of red signals appeared within five to six hours after operation,there was significant difference of Emean value at various periods after operation in group C and U,and at each period except instant,2 h,and 3 h postoperatively between group C and U(P<0.05).Postoperative Emean value in spermatic cord torsion lower section in group U and C increased slowly(P<0.05),expression of SWE changed from blue to blue green and green from original blue.CEUS showed
作者
林璐琳
薛恩生
洪龙城
庄细强
苏唤忠
陈聪
林文金
Lin Lulin;Xue Ensheng;Hong Longcheng;Zhuang Xiqiang;Su Huanzhong;Chen Cong;Lin Wenjin(Deparrtment of Ultrasound,Fujian Medical University Union Hospital,Fuzhou 350001,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2020年第8期722-727,共6页
Chinese Journal of Ultrasonography
基金
福建省教委科研基金(JA15220)。
关键词
实时剪切波弹性成像
睾丸扭转
超声造影
Real-time shear wave elastography
Testicular torsion
Contrast-enhanced ultrasound
