radiologyРадиология — практикаRadiology - Practice2713-0118Центральный научно-исследовательский институт лучевой диагностики10.52560/2713-0118-2021-5-54-68radiology-168Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHРоль серошкального ультразвукового исследования в диагностике постнатального перекрута яичка у детейThe Role of Gray-Scale Ultrasound in the Diagnosis of Postnatal Testicular Torsion in Childrenhttps://orcid.org/0000-0003-3757-8001ОльховаЕ. Б.OlkhovaE. B.

Ольхова Елена Борисовна, доктор медицинских наук, профессор, профессор кафедры лучевой диагностики; заведующая отделением ультразвуковой диагностики

127206, г. Москва, ул. Вучетича, д. 9а

Тел.: + 7(495) 611-01-77

Olkhova Elena Borisovna, M. D. Med., Professor, Professor of Department of Radiology; the Head of Department of the Ultrasound Diagnostic

9а, ul. Vucheticha, Moscow, 127206, Russia

Phone number: +7 (495) 611-01-77

elena-olchova@bk.ruhttps://orcid.org/0000-0002-8664-4362ТопольникМ. В.TopolnikM. V.

Топольник Маргарита Владимировна, врач отделения ультразвуковой диагностики

107014, г. Москва, ул. Рубцовско-Дворцовая, д. 1/3

Тел.: +7 (499) 268-83-87

Topolnik Margarita Vladimirovna, Radiologist of Department of Ultrasound Diagnostic

1/3, ul. Rubtsovsko-Dvortsovaya, Moscow, 107014, Russia

Phone number: +7 (499) 268-83-87

topolnik.margo@mail.ruhttps://orcid.org/0000-0002-8098-6441РудинА. Ю.RudinA. Yu.

Рудин Андрей Юрьевич, врач отделения урологии

107014, г. Москва, ул. Рубцовско-Дворцовая, д. 1/3

Тел.: +7 (499) 268-83-87

Rudin Andrey Yurievich, urologist of Department of Ultrasound Diagnostic

1/3, ul. Rubtsovsko-Dvortsovaya, Moscow, 107014, Russia

Phone number: +7 (499) 268-54-75

andrey-rudin@mail.ruhttps://orcid.org/0000-0002-8768-4171РуненкоВ. И.RunenkoV. I.

Руненко Владимир Игоревич, заведующий отделением урологии

107014, г. Москва, ул. Рубцовско-Дворцовая, д. 1/3

Тел.: + 7(495) 611-01-77

Runenko Vladimir Igorevich, the Head of Department of the Urology

1/3, ul. Rubtsovsko-Dvortsovaya, Moscow, 107014, Russia

Phone number: +7 (499) 268-54-75

dexon@mail.ruhttps://orcid.org/0000-0003-1362-6347МельникИ. В.MelnikI. V.

Мельник Инна Вячеславовна, врач ультразвуковой диагностики, заведующая отделением ультразвуковой диагностики

143081, Московская область, Одинцовский район, 1-е Успенское шоссе, Лапино, д. 111

Тел.: + 7(495) 526-60-60

Melnik Inna Vyacheslavovna, ultrasound specialist, the Head of Ultrasound Departament 2

111, 1 Uspenskoe highway, Lapino, Moscow region, Odintsovskii district, 143081, Russia

Phone number: + 7 (495) 526-60-60

vita_76@list.ruФГБОУ ВО «Московский государственный медико-стоматологический университет имени А. И. Евдокимова» Минздрава России; ГБУЗ «Детская городская клиническая больница Святого Владимира» Департамента здравоохранения города МосквыРоссияMoscow State University of Medicine and Dentistry named after A. I. Evdokimov, Department of Radiology, Ministry of Healthcare of Russia; Moscow Clinical Municipal Children Hospital St. Vladimir of the Department of Healthcare of MoscowRussian FederationГБУЗ «Детская городская клиническая больница Святого Владимира» Департамента здравоохранения города МосквыРоссияMoscow Clinical Municipal Children Hospital St. Vladimir of the Department of Healthcare of MoscowRussian FederationКлинический госпиталь «Лапино» ООО «ХАВЕН» группа компаний «Мать и дитя»РоссияClinical hospital «Lapino» LLC HAVEN Company group Mother and ChildRussian Federation202121062021055468Copyright © Ольхова Е.Б., Топольник М.В., Рудин А.Ю., Руненко В.И., Мельник И.В., 20212021Ольхова Е.Б., Топольник М.В., Рудин А.Ю., Руненко В.И., Мельник И.В.Olkhova E.B., Topolnik M.V., Rudin A.Y., Runenko V.I., Melnik I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.radp.ru/jour/article/view/168

Перекрут яичка является тяжелым вариантом постнатальной патологии гонад у детей. Быстрота развития необратимых ишемических нарушений определяет не только медицинскую, но и социальную значимость проблемы и обуславливает необходимость точной и быстрой диагностики и скорейшего оказания пациенту адекватной помощи. Единственным объективным методом диагностики перекрута яичка у детей является УЗИ. При этом особенности детского организма – малые размеры объекта исследования, низкие скорости интратестикулярного кровотока и беспокойное поведение во время исследования — резко снижают диагностическую ценность допплеровского исследования или делают его технически невозможным. Таким образом, серошкальное УЗИ является первым этапом диагностики этой сложной неотложной патологии, основываясь на результатах которого можно с большой точностью диагностировать перекрут яичка. В публикации обобщен собственный опыт 110 эхографических наблюдений постнатального перекрута яичка у детей старше 2 мес, все случаи верифицированы интраоперационно. Предложен количественный метод оценки деформации перекру ченного яичка и доказана его статистическая достоверность. Представлены варианты серошкальных изменений структуры поврежденной гонады и определена их прогностическая значимость. Публикация содержит обзор литературы и обширно иллюстрирована.

Testicular torsion is a severe variant of postnatal gonad pathology in children. The speed of development of irreversible ischemic disorders determines not only the medical, but also the social significance of the problem and determines the need for accurate and rapid diagnosis and prompt provision of adequate care to the patient. The only objective method for diagnosing testicular torsion in children is ultrasound. At the same time, the characteristics of the child’s body: the small size of the object of study, low rates of intratesticular blood flow and restless behavior during the study sharply reduce the diagnostic value of the Doppler study or make it technically impossible. Thus, seroshkal ultrasound is the first stage of diagnosis of this complex emergency pathology, based on the results of which it is possible to diagnose testicular torsion with great accuracy. The publication summarizes our own experience of 110 echographic observations of postnatal testicular torsion in children older than 2 months, all cases were verified intraoperatively. A quantitative method for estimating the deformity of a twisted testicle is proposed and its statistical reliability is proved. The options presented for gray-scale changes in the structure of damaged gonads and determined their prognostic significance. The publication contains a review of the literature and is extensively illustrated.

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The authors declare that there are no conflicts of interest present.