Giá trị của siêu âm trong chẩn đoán ẩn tinh hoàn không sờ thấy

Abstract

Impalpable undescended testis accounts for approximately 20% of all undescended testes, and accurate localization of the testis is important for treatment plan. This retrospective study assessed the diagnostic performance of ultrasonography in 95 males with unilateral impalpable undescended testis who underwent laparoscopic surgery at Vietnam National Children’s Hospital; the median age was 30 months old. Laparoscopic findings showed that low intra-abdominal testes accounted for 53.7%, while absent/atrophic testes accounted for 23.2%. Ultrasonography yielded a sensitivity of 68.5%, specificity of 63.6%, and overall accuracy of 67.4%, with lower sensitivity for high intra-abdominal testes (42.9%). In males aged 6 - 24 months old, compensatory enlargement of the contralateral testis predicted an absent/atrophic ipsilateral testis with good discriminative ability (AUC 0.917); a contralateral testicular length cutoff of 16 mm provided 89% sensitivity and 92% specificity. In conclusion, ultrasonography combined with contralateral testicular measurement is useful for initial assessment and preoperative counseling; however, diagnostic laparoscopy remains the definitive diagnostic method.