Testis torsiyonu: BT’de tesadüfi şüphe

Özet

Testis torsiyonu spermatik kordun dönmesiyle testis perfüzyonunun bozulduğu, zaman duyarlı bir ürolojik acildir. BT akut skrotum için uygun test değildir; karın-pelvis BT’sinde skrotuma giren testis veya kordda torsiyonu düşündüren bulgu görülürse acil klinik bildirim gerekir. BT’de skrotuma yakın alt kesitlerde girdap işareti insanlarda testis torsiyonu olgusunda bildirilmiştir; bu olgu sunumu testis asimetrisi veya çevre değişikliklerinin BT’de özgüllüğünü belirlemez. BT’de torsiyon bulgularına ilişkin insan verisi olgu sunumlarıyla sınırlıdır ve BT testis perfüzyonunu güvenilir biçimde değerlendiremez.

Faz ve pencere

Portal

BT’nin skrotuma yakın alt kesitlerinde kord girdap görünümü aranabilir; bu bulgu insanlarda testis torsiyonu olgusunda bildirilmiştir. İnsanlarda BT’de skrotuma yakın girdap işareti bir torsiyon olgu sunumunda bildirilmiştir; bu olgu testis asimetrisi, çevre sıvısı veya kontrastlanma değişiklikleri için tanı ölçütü sunmaz.

Önerilen pencereler: Yumuşak doku (G 400 / M 40), Batın (G 400 / M 50).

BT bulguları

• Görüntü alanına giren testiste taraflar arası boyut veya yerleşim asimetrisi — destekleyici olabilir ancak özgül ya da doğrulanmış bir BT ölçütü değildir.
• Skrotuma yakın alt BT kesitlerinde spermatik kordda girdap görünümü — kord girdap işareti
• Torsiyon olgularında hidrosel eşlik edebilir; ancak bu bulgu tek başına BT’de torsiyonu göstermez.
• İntraabdominal testis torsiyonunda kontrastlı BT’de kontrastlanmayan kitle ve kıvrılmış pedikül bildirilmiştir; bu bulgu insan olgu sunumuna dayanır.

Normalde

İntraabdominal testis torsiyonu olgu sunumunda boş hemiskrotum ve BT’de kıvrılmış pedikül bildirilmiştir. Torsiyon kuşkusunda BT’de testisin yerleşimini ve kord pedikülünün seyrini gözden geçir; intraabdominal testis torsiyonu olgusunda BT’de kıvrılmış pedikül bildirilmiştir.

Ayırıcı tanı

Testis tümörü torsiyonla birlikte görülebilir; intraabdominal testis torsiyonu olgu sunumunda histopatoloji seminomu doğrulamıştır.

İnguinoskrotal herni

herni kesesi içinde barsak ansı bulunabilir; testis torsiyonu olgu sunumunda ise skrotuma yakın kordda girdap işareti bildirilmiştir.

Testis travması ve hematom

travma bağlamı, kontur bozukluğu veya kan ürünleri yoğunluğu eşlik edebilir

İnmemiş testiste torsiyon

testis skrotum yerine inguinal kanal veya karında bulunur; yerleşimi takip ederek değerlendirilir

Tuzaklar

• Kordun BT’de girdap şeklinde görünmesi nadir raporlanmıştır ve tek başına doğrulanmış duyarlılık ölçüsü değildir; akut ağrıda bulguyu acil torsiyon şüphesi olarak ilet.
• BT’de kord girdabı insanlarda olgu sunumlarında bildirilmiştir; bu bulgunun görülmemesinin torsiyonu dışlama performansı bu kaynaklarda tanımlanmamıştır.
• Testis torsiyonunda tercih edilen görüntüleme yöntemi ultrasonografidir; BT’de görülen kord girdabını tek başına kesin tanı sayma ve torsiyon kuşkusunda değerlendirmeyi geciktirme.

Kendini dene

1. Apandisit için çekilen BT’de skrotuma yakın alt kesitlerde kord girdap işareti görülüyor. Bu bulgu en çok hangi tanıyı düşündürür?

   • Testis torsiyonu
   • Epididimo-orşit
   • İnguinoskrotal herni
   • Testis tümörü
   Cevabı göster

   Testis torsiyonu. İnsanlarda BT’de skrotuma yakın kord girdap işareti bir testis torsiyonu olgu sunumunda bildirilmiştir. Bu işaret torsiyon şüphesi doğurur; tek başına kesin tanı ölçütü olduğu gösterilmemiştir.

2. İnsanlarda testis torsiyonunu düşündüren BT bulgusu olgu sunumunda nasıl tanımlanmıştır?

   • Skrotuma yakın kesitlerde kord girdap işareti
   • Her iki testiste simetrik kontrastlanma
   • Skrotal duvarda kalınlaşma
   • Testis parankiminde kaba heterojenlik
   Cevabı göster

   Skrotuma yakın kesitlerde kord girdap işareti. BT olgu sunumunda skrotuma yakın alt kesitlerde kord girdap işareti bildirilmiştir. Diğer seçenekler bu kaynaklarda torsiyon için doğrulanmış BT bulguları olarak tanımlanmamıştır.

İlgili konular

• Epididimo-orşit ve skrotal enfeksiyon
• Testis/epididim apsesi ve enfarkt taklitçisi

Kaynaklar

Bu sayfadaki 31 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 13 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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