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：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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. 超声诊断学(英文版) . 北京: 人民卫生出版社, 2002: 416-418.
2.	周永昌, 陈亚青. 男性生殖系疾病超声诊断与介入治疗. 北京: 科学技术文献出版社, 2013: 167-170.
3.	王富军, 韩哲. 以急性腹痛为首发症状的青少年及幼儿睾丸扭转临床分析. 中华泌尿外科杂志, 2015(6): 454-457.
4.	阳世宇, 许宏. 症状不典型睾丸扭转 7 例并文献复习. 中华男科学杂志, 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, 张爱民, 包峰柏. 睾丸扭转误诊为腹股沟斜疝嵌顿一例. 临床误诊误治, 2017, 30(1): 61.
7.	刘国林, 查金智, 吴博. 以阴囊损害为首发症状的过敏性紫癜误诊为睾丸扭转一例并文献复习. 海南医学, 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.	郝建伟, 杜广辉, 丁德刚, 等. 精索形态观察在睾丸扭转早期诊治中的意义. 中华男科学杂志, 2012, 18(5): 419-421.
10.	姚巍. 精索螺旋状扭曲在采用高频超声诊断睾丸扭转中的价值. 中国医学工程, 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, 祝黎伟. 高频超声诊断小儿睾丸扭转的临床价值. 中国中西医结合影像学杂志, 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.	李红学, 李航. 超声造影在睾丸扭转中的诊断价值. 医学研究杂志, 2015, 44(1): 69-72.
17.	张青, 曹礼庭, 顾鹏. 高频彩色多普勒超声诊断不完全性睾丸扭转自动复位 1 例. 中国超声医学杂志, 2011, 27(3): 286-287.
18.	熊由富, 孙静, 贺国华, 等. 彩色多普勒超声诊断间断性睾丸扭转的体会. 临床超声医学杂志, 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.	孙建新, 王哲, 党笑坤. 睾丸急性扭转手法复位前后超声表现 1 例. 临床超声医学杂志, 2014, 16(9): 601, 605.
23.	曹刚, 唐欧杉, 陈建荣, 等. 超声引导手法复位治疗睾丸扭转的临床价值. 中华超声影像学杂志, 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.	陈海, 柳辉艳. 睾丸扭转. 把握黄金 6 小时. 家庭用药, 2012, 8: 64.

1. 安塞特. 超声诊断学(英文版) . 北京: 人民卫生出版社, 2002: 416-418.
2. 周永昌, 陈亚青. 男性生殖系疾病超声诊断与介入治疗. 北京: 科学技术文献出版社, 2013: 167-170.
3. 王富军, 韩哲. 以急性腹痛为首发症状的青少年及幼儿睾丸扭转临床分析. 中华泌尿外科杂志, 2015(6): 454-457.
4. 阳世宇, 许宏. 症状不典型睾丸扭转 7 例并文献复习. 中华男科学杂志, 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, 张爱民, 包峰柏. 睾丸扭转误诊为腹股沟斜疝嵌顿一例. 临床误诊误治, 2017, 30(1): 61.
7. 刘国林, 查金智, 吴博. 以阴囊损害为首发症状的过敏性紫癜误诊为睾丸扭转一例并文献复习. 海南医学, 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. 郝建伟, 杜广辉, 丁德刚, 等. 精索形态观察在睾丸扭转早期诊治中的意义. 中华男科学杂志, 2012, 18(5): 419-421.
10. 姚巍. 精索螺旋状扭曲在采用高频超声诊断睾丸扭转中的价值. 中国医学工程, 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, 祝黎伟. 高频超声诊断小儿睾丸扭转的临床价值. 中国中西医结合影像学杂志, 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. 李红学, 李航. 超声造影在睾丸扭转中的诊断价值. 医学研究杂志, 2015, 44(1): 69-72.
17. 张青, 曹礼庭, 顾鹏. 高频彩色多普勒超声诊断不完全性睾丸扭转自动复位 1 例. 中国超声医学杂志, 2011, 27(3): 286-287.
18. 熊由富, 孙静, 贺国华, 等. 彩色多普勒超声诊断间断性睾丸扭转的体会. 临床超声医学杂志, 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. 孙建新, 王哲, 党笑坤. 睾丸急性扭转手法复位前后超声表现 1 例. 临床超声医学杂志, 2014, 16(9): 601, 605.
23. 曹刚, 唐欧杉, 陈建荣, 等. 超声引导手法复位治疗睾丸扭转的临床价值. 中华超声影像学杂志, 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. 陈海, 柳辉艳. 睾丸扭转. 把握黄金 6 小时. 家庭用药, 2012, 8: 64.

West China Medical Journal

Sonographic findings of testicular torsion in adult males

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content