小儿未降睾丸的磁共振表现及其评价_临床医学论文.docVIP

小儿未降睾丸的磁共振表现及其评价_临床医学论文 小儿未降睾丸的磁共振表现及其评价_临床医学论文 作者：陈忠 练旭辉 梁长松 叶文钦 王晓波 文康彦 【摘要】 目的 评价小儿未降睾丸的ＭＲＩ表现及其临床价值。方法　对36例年龄在1～14岁临床发现阴囊空虚病人行MRI检查，33例单侧阴囊空虚，3例双侧阴囊空虚，34例经手术证实，2例因MR未检出未降睾丸而未行手术探查。回顾分析其MR表现并与手术结果对照。 结果 MRI正确显示未降睾丸34例(37枚)，检出率94.4%(34/36)，并经手术证实，34例中31例为单侧，3例为双侧，其中2例为异位睾丸，8例合并斜疝。结论 无创性、无辐射性、多方位成像的MRI能揭示小儿未降睾丸的解剖及组织学特征,图像清晰直观，最佳的成像平面为横断位及冠状位。有利于对并发症提供一定依据。 【关键词】 隐睾症 磁共振成像 [Abstract] Objective To evaluate the clinical value and findings of MR in children with undescended testis. Methods 36 children with vacant scrotum underwent MR scanning, who had single vacant scrotum in 33 patients and both sides in 3 patients. Their age was from 1 to 14 years old. Thirty-four cases were approved by operation. The operation had not been performed because of failure to localize the testes with MR in the other 2 cases. The results of operation were compared with MR findings retrospectively. Results Thirty-four(of 37)cases with undescented testes were displayed on MR. The accuracy rate was 94.4%(34/36). Of 34 patients, there were 31 in single side, 3 in both sides. Two cases were ectopic testis and 8 cases were accompanied by oblique hernia. Conclusion MR imaging ,with the advantages of noninvasive, nonradiation, multi-planar capability and clear and direct imaging, can also visualize the anatomical and histological characteristics of undescended testis.The imaging were showed clearly and directly. The optimal imaging planes are the axial and coronal planes. MRI can provide some information in the evaluation of complication. [Key words] cryptorchidism; magnetic resonance imaging 未降睾丸(undescended testis)又名隐睾(cryptorchism),是指睾丸未能按照正常发育过程从腰部腹膜后下降达阴囊底部。分为睾丸下降不全及睾丸异位两型[1]。为小儿外科的常见疾病,其影像学检查手段包括超声、血管造影、ECT、CT及MRI等[2～7],国外学者应用MRI对未降睾丸进行诊断积累了—定的经验,国内报道甚少。笔者曾报道过15例(18枚)未降睾丸的MRI诊断[8],其中小儿9例。近年来我院新增小儿25例，共36例，对其MRI诊断有进一步认识并作一回顾性分析,旨在探讨MRI对小儿未降睾丸的诊断表现及其临床价值。 材料与方法 1. 临床资料 36例男性患者，年龄1～14岁，平均年龄8.5岁。33例临床发现单侧阴囊空虚，3例为双侧阴囊空虚，经2位有经验主治医师触诊，16例无法满意扪及或无法扪及未降睾丸的位置，对全部36例未降睾丸病人行MRI检查，34例经手术证实。2例MR未检出