Zusammenfassung
Der Ultraschall ist die bildgebende Methode der Wahl bei Erkrankungen des Skrotums. Durch die Entwicklung hochauflösender Schallköpfe, mittels Farbdoppler und gepulsten Dopplers ist heute eine adäquate Diagnose möglich, die von keiner anderen Bildgebung erreicht werden kann. Die Sonographie kann unverzüglich zwischen intra- und extratestikulären Läsionen differenzieren, weiterhin ist eine Unterscheidung in zystisch und solide möglich. Solide Hodentumoren lassen sich problemlos nachweisen, was praktisch einer Dignitätsbeurteilung gleichkommt (98 % der soliden Hodentumoren sind maligne). Beim akuten Skrotum gelingt durch die Sonographie meist eine Differenzierung zwischen Torsion und Inflammation, unnötige Operationen werden somit vermieden. Die Übersichtsarbeit gliedert sich in Einführung, Ultraschallanatomie, Untersuchungstechnik und pathologische Veränderungen. Die Hodentumoren und die Torsion werden eingehend erörtert, Normvarianten und Fallgruben werden skizziert, um Fehldiagnosen zu vermeiden.
Abstract
Ultrasonography (US) has become the method of choice for imaging in diseases affecting the scrotum. With the development of high resolution transducers using colour Doppler and pulsed Doppler, it is now possible to make accurate diagnoses. Sonography is able to distinguish immediately between intra- and extratesticular lesions. It is also possible to differentiate between cystic and solid tumours. Solid testicular tumours may be detected without difficulty and thus the patient’s dignity is practically assured (98 % of solid testicular tumours are malignant). In cases of acute diseases of the scrotum, sonography nearly always permits a differentiation between torsion and inflammation, thus avoiding the risk of unnecessary operations. The review covers the introduction, anatomy, the scanning protocol for scrotal ultrasound and pathological changes. Testicular tumours and torsion are discussed in detail. Variations from the norm and pitfalls are outlined so as to help avoid making misdiagnoses.
Key words
Seminoma - ultrasound - scrotum - testes
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Dr. Gerald Lesnik
Röntgendiagnostisches Zentralinstitut, Landeskrankenhaus Klagenfurt
St. Veiterstraße 47
9020 Klagenfurt
Österreich
Telefon: ++ 43/4 63/5 38-2 47 32
Fax: ++ 43/4 63/5 38-2 20 35
eMail: gerald.lesnik@lkh-klu.at
