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РАДИОЛОГИЧЕСКАЯ БИБЛИОТЕКА

22.04.2011 УЗИ мошонки. Острый эпидидимит

Мужчина 44 года, жалобы на боли в правом яичке отдающие в пах, отёк мошонки на стороне поражения. Вашему вниманию представлены сонограммы правого яичка.

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 эпидидимит с признаками

 эпидидимит с признаками деструкции, фуникулит, гидроцеле, утолщены мягкие ткани мошонки.

 
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Острый орхоэпидидимит.

Острый орхоэпидидимит. Увеличены, за счет отека, яичко, тело и хвост придатка, повышена васкуляризация. Деструктивных изменений нет

 
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Ostriy

Ostriy orkhoepididimit.Gidrocele.

 
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эпидидимит, умеренный

эпидидимит, умеренный гидроцеле

 
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  Острый

 

Острый эпидидимит.

Ultrasonography

Ultrasonographic findings considered diagnostic of acute epididymitis include an enlarged (>17 mm) epididymis with a hypoechoic, hyperechoic, or heterogeneous echotexture (gray-scale ultrasonography) and increased blood flow (color or power Doppler ultrasonography) (see the images below).Associated reactive hydrocele and scrotal wall thickening may be present. Blood flow can be seen in a normal epididymis; therefore, the mere presence of blood flow should not be considered the sine qua non of epididymitis. It is the asymmetrical increase (more in the affected epididymis) that is important.[14]

Transverse ultrasonogram of the testis shows an en

Transverse ultrasonogram of the testis shows an enlarged and predominantly hypoechoic epididymis with a reactive hydrocele in a patient with acute epididymitis.

Color-flow ultrasonogram shows increased vasculari

Color-flow ultrasonogram shows increased vascularity in the epididymis. An enlarged epididymis with increased vascularity in the appropriate clinical setting is diagnostic of acute epididymitis.

This ultrasonogram shows an enlarged epididymis wi

This ultrasonogram shows an enlarged epididymis with heterogeneous echotexture in a case of acute epididymitis.

The epididymis is primarily involved in epididymo-orchitis, with orchitis developing in about 20-40% of cases by means of direct spread. Diffuse testicular involvement is confirmed with testicular enlargement and an inhomogeneous echotexture. These findings are nonspecific, but acute epididymo-orchitis is the most common disease with this pattern. This pattern of heterogeneous echotexture can also occur in patients with tumors, metastasis, and infarction. Therefore, patients with these conditions should be followed up with ultrasonography to demonstrate complete resolution.

The readily detectable intratesticular venous flow is highly suggestive of orchitis. Analysis of the spectral waveform also can provide useful information. In the testes of a healthy volunteer, the resistive index (RI) is rarely less than 0.5, but more than half of the patients with epididymo-orchitis have an RI of less than 0.5.

Degree of confidence

Ultrasonography is the first-line imaging modality for evaluating a patient with suspected acute epididymo-orchitis. The sensitivity of color Doppler ultrasonography in detecting scrotal inflammation is almost 100%.

False positives/negatives

Usually, no false-positive or false-negative findings occur. However, the epididymis may be involved in some patients with testicular torsion. Hence, in every case of epididymitis, intratesticular blood flow should be carefully evaluated to exclude the possibility of acute testicular torsion.

 
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Спасибо,Марио,очень четкий

Спасибо,Марио,очень четкий снимок.Удачно охвачен весь эпидидим

 
 

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