radiologyРадиология — практикаRadiology - Practice2713-0118Центральный научно-исследовательский институт лучевой диагностики10.52560/2713-0118-2021-5-69-81radiology-173Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHРоль допплеровского ультразвукового исследования в диагностике постнатального перекрута яичка у детейThe Role of Doppler 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/0000-0002-5176-3150БорисовС. Ю.BorisovS. Yu.

Борисов Сергей Юрьевич, врач отделения ультразвуковой диагностики

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

Тел.: +7 (499) 268-83-87

Borisov Sergei Yurievich, Radiologist of Department of Ultrasound Diagnostic

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

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

borisovsergdoc@gmail.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/0000-0001-6167-4525ТагироваА. Ю.TagirovaA. Yu.

Тагирова Анапиче Юзбеговна, врач отделения ультразвуковой диагностики

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

Тел.: +7 (499) 268-83-87

Tagirova Anapiche Yuzbegovna, Radiologist of Department of Ultrasound Diagnostic

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

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

adinatagirova@mail.ruhttps://orcid.org/0000-0002-4269-5811ЖумаситовС. В.ZhumasitovS. V.

Жумаситов Салават Викторович, врач отделения ультразвуковой диагностики

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

Тел.: +7 (499) 268-83-87

Zhumasitov Salavat Viktorovich, Radiologist of Department of Ultrasound Diagnostic

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

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

vala199020slav@yandex.ruhttps://orcid.org/0000-0002-2070-7607МукасееваТ. В.MukaseevaT. V.

Мукасеева Татьяна Викторовна, врач отделения ультразвуковой диагностики

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

Тел.: +7 (499) 268-83-87

Mukaseeva Tatyana Viktorovna, Radiologist of Department of Ultrasound Diagnostic

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

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

tatiana-mukaseeva@mail.ruФГБОУ ВО «Московский государственный медико-стоматологический университет имени А. И. Евдокимова» Минздрава России; ГБУЗ «Детская городская клиническая больница Святого Владимира Департамента здравоохранения города Москвы»РоссияMoscow 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, Moscow Healthcare DepartmentRussian FederationГБУЗ «Детская городская клиническая больница Святого Владимира Департамента здравоохранения города Москвы»РоссияMoscow Clinical Municipal Children Hospital St. Vladimir, Moscow Healthcare DepartmentRussian Federation202125062021056981Copyright © Ольхова Е.Б., Борисов С.Ю., Топольник М.В., Тагирова А.Ю., Жумаситов С.В., Мукасеева Т.В., 20212021Ольхова Е.Б., Борисов С.Ю., Топольник М.В., Тагирова А.Ю., Жумаситов С.В., Мукасеева Т.В.Olkhova E.B., Borisov S.Y., Topolnik M.V., Tagirova A.Y., Zhumasitov S.V., Mukaseeva T.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/173

Диагностическая значимость цветового допплеровского исследования тестикулярного кровотока при перекруте яичка изучается уже на протяжении около 40 лет, тем не менее прогностическая ценность полученных результатов неоднозначна, как неоднозначны и собственно визуализирующие возможности методики. Собственный опыт 110 наблюдений перекрута яичек у детей старше периода новорожденности позволяет сделать статистически достоверные выводы. Выполненные на аппаратуре преимум-класса исследования позволили оценить как возможности визуализации интратестикулярного сосудистого рисунка, так и whirpool-sign, а также представить примитивную модель собственно заворота, объясняющую невозможность визуализации whirpool-sign при максимально тугом завороте. Изучена динамика тестикулярного кровотока непосредственно после успешной и неуспешной мануальной деторсии и в отдаленные сроки после оперативной деторсии и орхипексии.

Публикация содержит краткий анализ литературы и обширно иллюстрирована.

The diagnostic significance of the color Doppler study of testicular blood flow in testicular torsion has been studied for about 40 years, however, the prognostic value of the results obtained is ambiguous, as are the actual imaging capabilities of the technique. Our own experience of 110 observations of testicular torsion in children older than the neonatal period allows us to draw statistically reliable conclusions. Made on equipment premium-class research made it possible to evaluate how visualization intratesticular vascular pattern, and whirpool-sign and submit the primitive model of the actual inversion, explaining the impossibility of rendering whirpool-sign with the greatest tight inversion. The dynamics of testicular blood flow was studied immediately after successful and unsuccessful manual detorsion and in the long term after operative detorsion and orchopexy. The publication contains a brief analysis of the literature and is extensively illustrated.

ультразвуковая диагностикадетиперекрут яичкаUltrasonographyChildrenTesticular TorsionReferencesAdams Ch. R. M., Del Gaizo A. J. The utility of scrotal ultrasonography in the emergent setting: beyond epididymitis versus torsion. Emerg. Radiol. 2018. V. 25. No. 4. P. 341–348.Adams Ch. R. M., Del Gaizo A. J. The utility of scrotal ultrasonography in the emergent setting: beyond epididymitis versus torsion. Emerg. Radiol. 2018. V. 25. No. 4. P. 341–348.Afsarlar C. E., Ryan Sh. L., Donel E., Baccam T. H., Jones B., Chandwani B., Au J., Huang G. O., Gonzales E. T., Janzen N., Tu D., Seth A., Roth D. R., Koh Ch. J. Standardized process to improve patient flow from the Emergency Room to the Operating Room for pediatric patients with testicular torsion. J. Pediatr. Urol. 2016. V. 12. No. 4. P. 233.e1–4.Afsarlar C. E., Ryan Sh. L., Donel E., Baccam T. H., Jones B., Chandwani B., Au J., Huang G. O., Gonzales E. T., Janzen N., Tu D., Seth A., Roth D. R., Koh Ch. J. Standardized process to improve patient flow from the Emergency Room to the Operating Room for pediatric patients with testicular torsion. J. Pediatr. Urol. 2016. V. 12. No. 4. P. 233.e1–4.Altinkilic B., Pilatz A., Weidner W. Detection of normal intratesticular perfusion using color coded duplex sonography obviates need for scrotal exploration in patients with suspected testicular torsion. J. Urol. 2013. V. 189. No. 5. P. 1853–1858.Altinkilic B., Pilatz A., Weidner W. Detection of normal intratesticular perfusion using color coded duplex sonography obviates need for scrotal exploration in patients with suspected testicular torsion. J. Urol. 2013. V. 189. No. 5. P. 1853–1858.Bandarkar A. N., Blask A. R. Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis. Pediatr. Radiol. 2018. V. 48. No. 5. P. 735–744.Bandarkar A. N., Blask A. R. Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis. Pediatr. Radiol. 2018. V. 48. No. 5. P. 735–744.Dowall J. M., Adam A., Gerber L., Enyuma C. O. A., Aigbodion S. J., Buchanan S., Laher A. E. The ultrasonographic «whirlpool sign» in testicular torsion: valuable tool or waste of valuable time? A systematic review and meta-analysis. Emerg. Radiol. 2018. V. 25. No. 3. P. 281–292.Dowall J. M., Adam A., Gerber L., Enyuma C. O. A., Aigbodion S. J., Buchanan S., Laher A. E. The ultrasonographic «whirlpool sign» in testicular torsion: valuable tool or waste of valuable time? A systematic review and meta-analysis. Emerg. Radiol. 2018. V. 25. No. 3. P. 281–292.Galina P., Dermentzoglou V., Baltogiannis N., Zarifi M. Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler. Pediatr. Radiol. 2015. V. 45 No. 11. P. 1661–1671.Galina P., Dermentzoglou V., Baltogiannis N., Zarifi M. Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler. Pediatr. Radiol. 2015. V. 45 No. 11. P. 1661–1671.Guo X., Sun L., Lei W., Li Sh., Guo H. Management of testicular torsion <360° in children: a single-center, retrospective study // J. Int. Med. Res. 2020. V. 48. No. 4. 300060519895861.Guo X., Sun L., Lei W., Li Sh., Guo H. Management of testicular torsion <360° in children: a single-center, retrospective study // J. Int. Med. Res. 2020. V. 48. No. 4. 300060519895861.Hayn M. H., Herz D. B., Bellinger M. F., Schneck F. X. Intermittent torsion of the spermatic cord portends an increased risk of acute testicular infarction. J. Urol. 2008. V. 180. No. 4. Suppl. P. 1729–1732.Hayn M. H., Herz D. B., Bellinger M. F., Schneck F. X. Intermittent torsion of the spermatic cord portends an increased risk of acute testicular infarction. J. Urol. 2008. V. 180. No. 4. Suppl. P. 1729–1732.Kaye J. D., Shapiro E. Y., Levitt S. B., Friedman St. C., Gitlin J., Freyle J., Palmer L. S. Parenchymal echo texture predicts testicular salvage after torsion: potential impact on the need for emergent exploration. J. Urol. 2008. V. 180. No. 4. Suppl. P. 1733–1736.Kaye J. D., Shapiro E. Y., Levitt S. B., Friedman St. C., Gitlin J., Freyle J., Palmer L. S. Parenchymal echo texture predicts testicular salvage after torsion: potential impact on the need for emergent exploration. J. Urol. 2008. V. 180. No. 4. Suppl. P. 1733–1736.Materny J., Dymny M., Lesiewska L., Gawrych E. Assessment of the validity of Doppler sonography in the diagnosis of acute scrotum in boys Pomeranian. J. Life Sci. 2015. V. 61. No. 2. P. 163–166.Materny J., Dymny M., Lesiewska L., Gawrych E. Assessment of the validity of Doppler sonography in the diagnosis of acute scrotum in boys Pomeranian. J. Life Sci. 2015. V. 61. No. 2. P. 163–166.Munden M. M., Williams J. L., Zhang W., Crowe J. E., Munden R. F., Cisek L. J. Intermittent testicular torsion in the pediatric patient: sonographic indicators of a difficult diagnosis // AJR Am. J. Roentgenol. 2013. V. 201. No. 4. P. 912–918.Munden M. M., Williams J. L., Zhang W., Crowe J. E., Munden R. F., Cisek L. J. Intermittent testicular torsion in the pediatric patient: sonographic indicators of a difficult diagnosis // AJR Am. J. Roentgenol. 2013. V. 201. No. 4. P. 912–918.Obi A. O. Intermittent testicular torsion. Niger. J. Clin. Pract. 2017. V. 20. No. 10. P. 1273–1276.Obi A. O. Intermittent testicular torsion. Niger. J. Clin. Pract. 2017. V. 20. No. 10. P. 1273–1276.Patoulias D., Farmakis K., Kalogirou M., Patoulias I. Transient testicular torsion: from early diagnosis to appropriate therapeutic intervention (a prospective clinical study) // Folia Med. Cracov. 2017. V. 57. No. 2. P. 53–62.Patoulias D., Farmakis K., Kalogirou M., Patoulias I. Transient testicular torsion: from early diagnosis to appropriate therapeutic intervention (a prospective clinical study) // Folia Med. Cracov. 2017. V. 57. No. 2. P. 53–62.Prando D. Torsion of the spermatic cord: the main gray-scale and doppler sonographic signs. Abdom. Imaging. 2009. V. 34. No. 5. P. 648–661.Prando D. Torsion of the spermatic cord: the main gray-scale and doppler sonographic signs. Abdom. Imaging. 2009. V. 34. No. 5. P. 648–661.Tian X.-M., Tan X.-H., Shi Q.-L., Wen Sh., Lu P., Liu X., Li X.-L., He D.-W., Lin T., Wei G.-H. Risk Factors for Testicular Atrophy in Children With Testicular Torsion Following Emergent Orchiopexy. Front. Pediatr. 2020. V. 11. No. 8. P. 584796.Tian X.-M., Tan X.-H., Shi Q.-L., Wen Sh., Lu P., Liu X., Li X.-L., He D.-W., Lin T., Wei G.-H. Risk Factors for Testicular Atrophy in Children With Testicular Torsion Following Emergent Orchiopexy. Front. Pediatr. 2020. V. 11. No. 8. P. 584796.Vijayaraghavan S. B. Sonographic differential diagnosis of acute scrotum: realtime whirlpool sign, a key sign of torsion. J. Ultrasound. Med. 2006. V. 25. No. 5. P. 563–574.Vijayaraghavan S. B. Sonographic differential diagnosis of acute scrotum: realtime whirlpool sign, a key sign of torsion. J. Ultrasound. Med. 2006. V. 25. No. 5. P. 563–574.West J. M., Goates A. J., Brown J. A. A 26-Year-Old Male with a 14-Year History of Left Intermittent Testicular Torsion Treated with Self-Manual. Reduction. Curr. Urol. 2018. V. 11. No. 3. P. 166–168.West J. M., Goates A. J., Brown J. A. A 26-Year-Old Male with a 14-Year History of Left Intermittent Testicular Torsion Treated with Self-Manual. Reduction. Curr. Urol. 2018. V. 11. No. 3. P. 166–168.Yu K.-J., Wang T.-M., Chen H.-W., Wang H.-H. The dilemma in the diagnosis of acute scrotum: clinical clues for dif ferentiating between testicular torsion and epididymo-orchitis. Chang. Gung. Med. J. 2012. V. 35. No. 1. P. 38–45.Yu K.-J., Wang T.-M., Chen H.-W., Wang H.-H. The dilemma in the diagnosis of acute scrotum: clinical clues for dif ferentiating between testicular torsion and epididymo-orchitis. Chang. Gung. Med. J. 2012. V. 35. No. 1. P. 38–45.

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