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    EUS教學 (19) 急診超音波在睪丸急症之應用

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    juice119
    Testicular Torsion Most common in 12-18 years Golden hours: 6 hours. Most common: 12-year-old boy with right-sided scrotal pain for 6hrs.

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    EUS教學 (19) 急診超音波在睪丸急症之應用

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    juice119
    957 views58 pages
    Testicular Torsion Most common in 12-18 years Golden hours: 6 hours. Most common: 12-year-old boy with right-sided scrotal pain for 6hrs.

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    EUS教學_(19)急診超音波在睪丸急症之應用

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    Testicular Torsion Most common in 12-18 years Golden hours: 6 hours. Most common: 12-year-old boy with right-sided scrotal pain for 6hrs.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    957 views58 pages

    EUS教學 (19) 急診超音波在睪丸急症之應用

    Uploaded by

    juice119
    Testicular Torsion Most common in 12-18 years Golden hours: 6 hours. Most common: 12-year-old boy with right-sided scrotal pain for 6hrs.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    Emergency Ultrasound (EUS)教學(19)

    急診超音波在睪丸急症之應用
    新光醫院急診醫學科
    陳國智醫師
    中華民國醫用超音波學會指導醫師
    Normal anatomy of the testis

    Testis: (L) 3-5 cm; (W) & (AP) 2-3 cm


    Epididymal head: < 1 cm
    J Clin Ultrasound;2010:38:21–37
    Normal scrotal anatomy and
    ultrasonographic appearance
    Homogeneous testicular
    echogenicity and echo texture Testicular blood flow

    J Ultrasound Med;2002: 21:171–185


    Normal tunica albuginea

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629

    © 2008 by Radiological Society of North America


    Mediastinum testis

    J Clin Ultrasound;2010:38:21–37
    Intratesticular artery

    J Ultrasound Med;2002: 21:171–185


    Normal testicular comparison

    J Ultrasound Med;2002: 21:171–185


    Normal epididymis

    Radiographics. 2007;27:357-69
    Color Doppler_head of the
    epididymis

    J Ultrasound Med;2002: 21:171–185


    Appendix
    Appendix testis Appendix epididymis

    J Ultrasound Med;2002: 21:171–185


    VARICOCELE

    J Clin Ultrasound;2010:38:21–37
    Varicocele

    J Ultrasound Med;2002: 21:171–185


    Varicocele in a 15-year-old boy

    Radiographics. 2005;25:1197-214
    Maldescent or Cryptorchidism
    • Undescended testis
    – inguinal canal 80%
    – Abdomene 20%

    • Infertility and cancer

    • US
    – preoperative
    localization

    J Clin Ultrasound;2010:38:21–37
    Undescended testes in a 36-year-old man
    Oval shaped, hypoechoic testis in inguinal canal

    Radiology. 2003;227:18-36
    HYDROCELE

    J Clin Ultrasound;2010:38:21–37
    Torsion
    Most common: 12-18 years
    Golden hours: 6 hours

    J Clin Ultrasound;2010:38:21–37
    Testicular torsion

    J Ultrasound Med;2002: 21:171–185


    Testicular torsion

    J Ultrasound Med;2002: 21:171–185


    Testicular torsion in a newborn with
    right testicle discoloration at birth

    Radiographics. 2005;25:1197-214
    Testicular torsion in a 13-year-old
    boy

    Radiographics. 2005;25:1197-214
    15M with left scrotal pain for 6hrs
    Testicular torsion in a 12-year-old boy
    with right-sided scrotal pain of sudden
    onset

    Radiographics. 2005;25:1197-214
    Normal and twisted testicular appendages

    Radiographics. 2005;25:1197-214
    Epididymo-orchitis

    J Clin Ultrasound;2010:38:21–37
    Epididymitis

    Surgical diagnosis: Epididymal abscess


    J Clin Ultrasound;2010:38:21–37
    Epididymitis

    J Ultrasound Med;2002: 21:171–185


    Epididymo-orchitis

    J Ultrasound Med;
    2002: 21:171–185
    Epididymitis in an 11-year-old boy

    Radiographics. 2005;25:1197-214
    29M with painful left scrotum
    Pyocele

    J Ultrasound Med;2002: 21:171–185


    Scrotal hematoma

    J Ultrasound Med;2002: 21:171–185


    Ruptured testicle after trauma

    J Ultrasound Med;2002: 21:171–185


    Fournier gangrene

    Radiology. 2003;227:18-36
    Inguinal hernia

    J Ultrasound Med;2002: 21:171–185


    Inguinal hernia
    Inguinoscrotal hernia
    5-month-old boy with scrotal
    swelling

    Radiographics. 2005;25:1197-214
    Scrotal edema

    J Clin Ultrasound;2010:38:21–37
    Microlithiasis

    J Ultrasound Med;2002: 21:171–185


    Testicular rupture

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629


    Intratesticular hematomas
    Immediately after trauma
    Heterogeneous echotexture F/U US 12 hours later

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629


    Testicular rupture

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629


    Intratesticular hematoma

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629

    © 2008 by Radiological Society of North America


    Testicular fracture

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629

    © 2008 by Radiological Society of North America


    Testicular torsion

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629

    © 2008 by Radiological Society of North America


    Infected testicular hematoma

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629


    Testicular pseudoaneurysm

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629

    © 2008 by Radiological Society of North America


    Gunshot wounds to the testis

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629


    Hematocele

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629

    © 2008 by Radiological Society of North America


    Hematoma after inguinal herniorrhaphy

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629


    Scrotal wall hematoma

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629

    © 2008 by Radiological Society of North America


    Traumatic epididymitis

    Bhatt S , Dogra V S Radiographics 2008;28:1617-1629


    Henoch-Scho¨nlein purpura in a 9-
    year-old boy with bilateral scrotal pain
    and swelling

    Bilateral scrotal wall thickening,


    epididymal enlargement,
    and reactive hydrocele
    Radiographics. 2005;25:1197-214
    Testicular torsion

    J Ultrasound Med 2010; 29:11–21


    Acute myeloid leukemia spread to the testis

    J Ultrasound Med 2010; 29:11–21


    J Ultrasound Med 2010; 29:11–21
    Take Home Message
    • 如果可能，選擇線形高解析探頭
    • 善用Doppler的功能
    • Testis注意
    – Smooth outline
    – Isoechoic echotexture
    – Adequate internal flow
    • 主要用來輔助Acute painful or swollen scrotum
    – Torsion
    – Epididymo-orchitis
    – Trauma-related complications
    – Obscure hernia

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