Sonographic findings of testicular torsion in adult males_West China Medical Journal

Authors：

JING Jigang ,  LI Yongzhong , ZHUANG Hua , PENG Yulan , LUO Yan

Department of Ultrasonography, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LI Yongzhong, Email: lyz917@126.com

Keywords：

Adult males; Testicular torsion; Ultrasound

DOI：

10.7507/1002-0179.201704009

Video：

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Objective To explore the sonographic features of testicular torsion in adult males (≥25 years). Method We retrospectively analyzed the clinical, pathological and sonographic data of 79 adult male patients with testicular torsion, in whom 20 underwent resection of testis and 59 retained testis in West China Hospital from September 2006 to March 2017. Results There were 56 patients with spermatic cord nodules or mass with the largest mass of about 36 mm ×31 mm; the scrotal wall thickened in 48 patients with the thickness of 5–10 mm; axial changes of the affected testis were found in 24 patients; there were 61 patients with testicular growth in the affected side, while the affected testis was reduced in 7; there were 67 patients with asymmetric echo in the affected side, and the maximum hypoechoic area was about 36 mm×26 mm; the epididymis of the affected side in 35 patients with were unclear, and the epididymis of the affected side was enlarged in 19; 25 patients had hydrocele of testis; there was no blood flow in 49, blood flow reduced in 25, and blood flow increased in 5. Four patients were diagnosed by contrast-enhanced ultrasound, and there was no enhancement in 3 and partial enhancement in 1. Conclusion The sonographic features of testicular torsion in adult males are obvious, and the early diagnosis of testicular torsion can be confirmed by contrast-enhanced ultrasonography.

Citation： JING Jigang, LI Yongzhong, ZHUANG Hua, PENG Yulan, LUO Yan. Sonographic findings of testicular torsion in adult males. West China Medical Journal, 2017, 32(10): 1555-1558. doi: 10.7507/1002-0179.201704009 Copy

1.	安塞特. 超聲診斷學(英文版) . 北京: 人民衛生出版社, 2002: 416-418.
2.	周永昌, 陳亞青. 男性生殖系疾病超聲診斷與介入治療. 北京: 科學技術文獻出版社, 2013: 167-170.
3.	王富軍, 韓哲. 以急性腹痛為首發癥狀的青少年及幼兒睪丸扭轉臨床分析. 中華泌尿外科雜志, 2015(6): 454-457.
4.	陽世宇, 許宏. 癥狀不典型睪丸扭轉 7 例并文獻復習. 中華男科學雜志, 2010, 16(8): 732-734.
5.	Sheth KR, Keays M, Grimsby GM, et al. Diagnosing testicular torsion before urologic consultation and imaging:a validation of the TWIST score. Journal of Urology , 2016, 195(6): 1870-1876.
6.	李月明, 張愛民, 包峰柏. 睪丸扭轉誤診為腹股溝斜疝嵌頓一例. 臨床誤診誤治, 2017, 30(1): 61.
7.	劉國林, 查金智, 吳博. 以陰囊損害為首發癥狀的過敏性紫癜誤診為睪丸扭轉一例并文獻復習. 海南醫學, 2016, 27(10): 1713-1714.
8.	Baud C, Veyrac C, Couture A, et al. Spiral twist of the spermatic cord: a reliable sign of testicular torsion. Pediatr Radiol, 1998, 28(12): 950-954.
9.	郝建偉, 杜廣輝, 丁德剛, 等. 精索形態觀察在睪丸扭轉早期診治中的意義. 中華男科學雜志, 2012, 18(5): 419-421.
10.	姚巍. 精索螺旋狀扭曲在采用高頻超聲診斷睪丸扭轉中的價值. 中國醫學工程, 2015(1): 43.
11.	Older RA, Watson LR. Ultrasound diagnosis of testicular torsion: beware the swollen epididymis. J Urol, 1997, 157(4): 1369-1370.
12.	Galina P, Dermentzoglou V, Baltogiannis N, et al. Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler. Pediatr Radiol, 2015, 45(11): 1661-1671.
13.	左汴京, 祝黎偉. 高頻超聲診斷小兒睪丸扭轉的臨床價值. 中國中西醫結合影像學雜志, 2014, 2: 191-193.
14.	Dogra VS, Sessions A, Mevorach RA, et al. Reversal of diastolic plateau in partial testicular torsion. J Clin Ultrasound, 2001, 29(2): 105-108.
15.	Cassar S, Bhatt S, Paltiel HJ, et al. Role of spectral Doppler sonography in the evaluation of partial testicular torsion. J Ultrasound Med, 2008, 27(11): 1629-1638.
16.	李紅學, 李航. 超聲造影在睪丸扭轉中的診斷價值. 醫學研究雜志, 2015, 44(1): 69-72.
17.	張青, 曹禮庭, 顧鵬. 高頻彩色多普勒超聲診斷不完全性睪丸扭轉自動復位 1 例. 中國超聲醫學雜志, 2011, 27(3): 286-287.
18.	熊由富, 孫靜, 賀國華, 等. 彩色多普勒超聲診斷間斷性睪丸扭轉的體會. 臨床超聲醫學雜志, 2013, 15(9): 660-661.
19.	Quddus MB, Mahmud SM. Testicular torsion: a diagnosis not to be missed. J Pak Med Assoc, 2011, 61(4): 391-392.
20.	Al-Kandari AM, Kehinde EO, Khudair S, et al. Intermittent testicular torsion in adults:an overlooked clinical condition, Med Princ Pract. 2017, 26(1): 30-34.
21.	Munden MM, Williams JL, Zhang W, et al. Intermittent testicular torsion in the pediatric patient: sonographic indicators of a difficult diagnosis. AJR Am J Roentgenol, 2013, 201(4): 912-918.
22.	孫建新, 王哲, 黨笑坤. 睪丸急性扭轉手法復位前后超聲表現 1 例. 臨床超聲醫學雜志, 2014, 16(9): 601, 605.
23.	曹剛, 唐歐杉, 陳建榮, 等. 超聲引導手法復位治療睪丸扭轉的臨床價值. 中華超聲影像學雜志, 2006, 15(1): 25-27.
24.	Allen TD, Elder JS. Shortcomings of color Doppler sonography in the diagnosis of testicular torsion. J Urol, 1995, 154(4): 1508-1510.
25.	Steinhardt GF, Boyarsky S, Mackey R. Testicular torsion: pitfalls of color Doppler sonography. J Urol, 1993, 150(2 Pt 1): 461-462.
26.	Tang YH, Yeung VH, Chu PS, et al. A 55-year-old man with right testicular pain:too old for torsion?. Urol Case Rep. 2017, 11: 74-75.
27.	Gomes DD, Vidal RR, Foeppel BF, et al. Cold weather is a predisposing factor for testicular torsion in a tropical country. A retrospective study. Sao Paulo Med J. 2015, 133(3): 187-190.
28.	Dunne PJ, O'loughlin BS. Testicular torsion: time is the enemy. Aust N Z J Surg, 2000, 70(6): 441-442.
29.	Kapoor S. Testicular torsion: a race against time. Int J Clin Pract, 2008, 62(5): 821-827.
30.	陳海, 柳輝艷. 睪丸扭轉. 把握黃金 6 小時. 家庭用藥, 2012, 8: 64.

1. 安塞特. 超聲診斷學(英文版) . 北京: 人民衛生出版社, 2002: 416-418.
2. 周永昌, 陳亞青. 男性生殖系疾病超聲診斷與介入治療. 北京: 科學技術文獻出版社, 2013: 167-170.
3. 王富軍, 韓哲. 以急性腹痛為首發癥狀的青少年及幼兒睪丸扭轉臨床分析. 中華泌尿外科雜志, 2015(6): 454-457.
4. 陽世宇, 許宏. 癥狀不典型睪丸扭轉 7 例并文獻復習. 中華男科學雜志, 2010, 16(8): 732-734.
5. Sheth KR, Keays M, Grimsby GM, et al. Diagnosing testicular torsion before urologic consultation and imaging:a validation of the TWIST score. Journal of Urology , 2016, 195(6): 1870-1876.
6. 李月明, 張愛民, 包峰柏. 睪丸扭轉誤診為腹股溝斜疝嵌頓一例. 臨床誤診誤治, 2017, 30(1): 61.
7. 劉國林, 查金智, 吳博. 以陰囊損害為首發癥狀的過敏性紫癜誤診為睪丸扭轉一例并文獻復習. 海南醫學, 2016, 27(10): 1713-1714.
8. Baud C, Veyrac C, Couture A, et al. Spiral twist of the spermatic cord: a reliable sign of testicular torsion. Pediatr Radiol, 1998, 28(12): 950-954.
9. 郝建偉, 杜廣輝, 丁德剛, 等. 精索形態觀察在睪丸扭轉早期診治中的意義. 中華男科學雜志, 2012, 18(5): 419-421.
10. 姚巍. 精索螺旋狀扭曲在采用高頻超聲診斷睪丸扭轉中的價值. 中國醫學工程, 2015(1): 43.
11. Older RA, Watson LR. Ultrasound diagnosis of testicular torsion: beware the swollen epididymis. J Urol, 1997, 157(4): 1369-1370.
12. Galina P, Dermentzoglou V, Baltogiannis N, et al. Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler. Pediatr Radiol, 2015, 45(11): 1661-1671.
13. 左汴京, 祝黎偉. 高頻超聲診斷小兒睪丸扭轉的臨床價值. 中國中西醫結合影像學雜志, 2014, 2: 191-193.
14. Dogra VS, Sessions A, Mevorach RA, et al. Reversal of diastolic plateau in partial testicular torsion. J Clin Ultrasound, 2001, 29(2): 105-108.
15. Cassar S, Bhatt S, Paltiel HJ, et al. Role of spectral Doppler sonography in the evaluation of partial testicular torsion. J Ultrasound Med, 2008, 27(11): 1629-1638.
16. 李紅學, 李航. 超聲造影在睪丸扭轉中的診斷價值. 醫學研究雜志, 2015, 44(1): 69-72.
17. 張青, 曹禮庭, 顧鵬. 高頻彩色多普勒超聲診斷不完全性睪丸扭轉自動復位 1 例. 中國超聲醫學雜志, 2011, 27(3): 286-287.
18. 熊由富, 孫靜, 賀國華, 等. 彩色多普勒超聲診斷間斷性睪丸扭轉的體會. 臨床超聲醫學雜志, 2013, 15(9): 660-661.
19. Quddus MB, Mahmud SM. Testicular torsion: a diagnosis not to be missed. J Pak Med Assoc, 2011, 61(4): 391-392.
20. Al-Kandari AM, Kehinde EO, Khudair S, et al. Intermittent testicular torsion in adults:an overlooked clinical condition, Med Princ Pract. 2017, 26(1): 30-34.
21. Munden MM, Williams JL, Zhang W, et al. Intermittent testicular torsion in the pediatric patient: sonographic indicators of a difficult diagnosis. AJR Am J Roentgenol, 2013, 201(4): 912-918.
22. 孫建新, 王哲, 黨笑坤. 睪丸急性扭轉手法復位前后超聲表現 1 例. 臨床超聲醫學雜志, 2014, 16(9): 601, 605.
23. 曹剛, 唐歐杉, 陳建榮, 等. 超聲引導手法復位治療睪丸扭轉的臨床價值. 中華超聲影像學雜志, 2006, 15(1): 25-27.
24. Allen TD, Elder JS. Shortcomings of color Doppler sonography in the diagnosis of testicular torsion. J Urol, 1995, 154(4): 1508-1510.
25. Steinhardt GF, Boyarsky S, Mackey R. Testicular torsion: pitfalls of color Doppler sonography. J Urol, 1993, 150(2 Pt 1): 461-462.
26. Tang YH, Yeung VH, Chu PS, et al. A 55-year-old man with right testicular pain:too old for torsion?. Urol Case Rep. 2017, 11: 74-75.
27. Gomes DD, Vidal RR, Foeppel BF, et al. Cold weather is a predisposing factor for testicular torsion in a tropical country. A retrospective study. Sao Paulo Med J. 2015, 133(3): 187-190.
28. Dunne PJ, O'loughlin BS. Testicular torsion: time is the enemy. Aust N Z J Surg, 2000, 70(6): 441-442.
29. Kapoor S. Testicular torsion: a race against time. Int J Clin Pract, 2008, 62(5): 821-827.
30. 陳海, 柳輝艷. 睪丸扭轉. 把握黃金 6 小時. 家庭用藥, 2012, 8: 64.

West China Medical Journal

Sonographic findings of testicular torsion in adult males

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