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隱睪症之放射線學定位
RADIOLOGIC LOCALIZATION OF UNDESCENDED TESTIS
摘要
隱睪症是小兒常見之一種疾病，如果不儘早治療，可能影響未來生殖能力及發生惡性變化。而剖腹探查既費時，可能亦會找不到未下降之睪丸；因此手術前之定位是必須的。我們以超音波檢查（US），電腦斷層攝影（CT）及生殖靜脈攝影（GV）使用於18位隱睪症患者之手術前定位（其中接受US 14位，CT 7位，GV 1位）。結果以US定位14例中有10例與手術所見相同，但如以US來定位於腹股溝之未下降睪丸，則13例中有11例與手術所見相同；以CT定位7例及以GV定位1例，均與手術所見相同。有一例閉兩側未下降睪丸，手術前CT己診斷有惡性變化，因而提供外科醫師正確之手術計劃。我們認為對於小兒隱睪症手術前影像學定位，首先以US來定位，尤其當未下降睪丸位於腹股溝時。如果US沒有找到未下降之睪丸，則進一步以CT來定位。對於青春期後隱睪症患者手術前影像學定位，則建議以CT來做第一線檢查。而當US及CT均無法找到未下降睪丸時，尤以無睪丸症或難以定位之未下降睪丸之情況時，則建議以GV來做進一步之後查。
關鍵字
無資料並列摘要
Because risk of failure of spermatogenesis and malignant degeneration, early treatment of cryptorchidism is recommended as soon as possible. Because of the length of time it takes for complete surgical exploration and because the testis may be missed during surgery, preoperative localization of the undescended testis is essential. Ultrasonography (US), computed tomography (CT) and gonadal venography (GV) were used for preoperative localization of undescended testis in 18 cryptorchid patients (among them, US were done in 14, CT in 7 and GV in 1). US was accurate in 10 among 14 cases, but was accurate in 11 among 13 cases if in localizing the undescended testis of the inguinal region. CT and GV were all accurate in localizing the undsecended testis. US and CT can improve the preoperative knowledge about testicular abnormalities in addition to localization of the undescended testis. We recommend US as the initial preoperative localization of the undescended testis in pediatric cryptorchid patients, especially if located in the inguinal region. If the result of US is equivocal or the undescended testis located higher in the abdomen, then CT is recommended. In patients with cyptorchidism after puberty, we recommend CT as the initial examination of preoperative localization of the undescended testis. If the undescended testis can not be found in the examinations of US and CT, gonadal venography is recommended.