上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (9): 1028-.doi: 10.3969/j.issn.1674-8115.2010.09.003

• 专题报道（影像医学与核医学） • 上一篇    下一篇

单侧睾丸扭转/复位致对侧睾丸损伤机制的超声造影研究

陈 林1,2, 刘振华1, 詹维伟1, 芮文斌3, 陈 曼1, 周建桥1, 姚洁洁1, 朱 樱1, 汪 欣1   

  1. 1.上海交通大学 医学院附属瑞金医院超声医学科, 上海 200025；2.复旦大学附属华东医院超声医学科, 上海 200040；3.上海交通大学 医学院附属瑞金医院泌尿外科, 上海 200025
  • 出版日期:2010-09-25 发布日期:2010-09-27
  • 通讯作者: 詹维伟, 电子信箱: shanghairuijin@126.com。
  • 作者简介:陈 林（1978—）, 男, 主治医师, 硕士；电子信箱: cl_point@126.com。
  • 基金资助:

    上海市科委自然科学基金(09411963400)

Contrast-enhanced ultrasound study of mechanism of unilateral testicular torsion and detorsion on injury of contralateral testes

CHEN Lin1,2, LIU Zhen-hua1, ZHAN Wei-wei1, RUI Wen-bin3, CHEN Man1, ZHOU Jian-qiao1, YAO Jie-jie1, ZHU Ying1, WANG Xin1   

  1. 1.Department of Ultrasonography, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China；2.Department of Ultrasonography, Huadong Hospital, Fudan University, Shanghai 200040, China；3.Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, |Shanghai 200025, China
  • Online:2010-09-25 Published:2010-09-27
  • Supported by:

    Shanghai Science and Technology Committee Foundation, 09411963400

PDF (PC)

1696

摘要：

目的 探讨单侧睾丸扭转/复位致对侧睾丸损伤的机制。方法 15只雄性家兔随机分为对照组、扭转组和扭转/复位组，每组5只。每组均进行3次实时超声造影后获取对侧睾丸标本，分析对侧睾丸超声造影时间—强度曲线参数、病理学改变（形态学观察和细胞凋亡指数计算）和生化指标变化。结果 ①单侧睾丸扭转后即刻，对侧睾丸灌注强度增加，表现为强度增量（EI）升高（P<0.05）；②复位后对侧睾丸灌注时间明显延长，主要表现为廓清时间（WT）延长（P<0.05）；③扭转及复位后均导致生殖细胞凋亡指数增加（P<0.05），并且复位后比单纯扭转凋亡指数增加更为明显（P<0.01）；④扭转及复位均导致睾丸组织一氧化氮（NO）含量、一氧化氮合酶（NOS）活力和超氧化物歧化酶（SOD）活力降低，丙二醛（MDA）含量升高，并且复位后的影响更为明显（P<0.01）。结论 扭转侧睾丸扭转/复位时缺血-再灌注损伤因子与对侧睾丸的灌注增加共同导致了对侧睾丸的损伤，并且对侧睾丸的灌注增加可能使损伤进一步加重。

关键词: 超声检查, 睾丸扭转, 缺血-再灌注, 兔

Abstract:

Objective To explore the mechanism of unilateral testicular torsion and detorsion on injury of contralateral testes injury with contrast-enhanced ultrasound. Methods Fifteen male New Zealand white rabbits were randomly divided into control group, torsion group, and torsion and detorsion group, with 5 rabbits in each group. Contralateral testis samples were obtained after three times of real-time ultrasound visualization in each group, and parameters of timeintensity curves, pathological changes and biochemical parameters of contralateral testes were analysed. Results ①The perfusion intensity of contralateral testes increased immediately after unilateral testicular torsion, and were characterised by the increase of enhancing intensity (EI)(P<0.05). ②The perfusion time of contralateral testes significantly increased after detorsion, and mainly presented as increased washout time (WT)(P<0.05). ③Apoptotic indexes (AI) of reproductive cells significantly increased after torsion or detorsion (P<0.05), and AI after detorsion were significantly higher than those after torsion (P<0.01). ④Both torsion and detorsion decreased content of nitrogen monoxidum (NO), activity of nitricoxide synthase (NOS) and superoxide dismutase (SOD), and increased content of malondialdehyde (MDA), and were more significant after detorsion (P<0.01). Conclusion The injury of contralateral testes with unilateral testicular torsion may results from ischemia-reperfusion injury factors of ipsilateral testes and blood perfusion enhancement of contralateral testes together.

Key words: ultrasonography, testicular torsion, ischemia-reperfusion, rabbit