male reproductive system X-ray

Male genital X-ray examination is mainly used to check the refined part, including epididymis, vas deferens, seminal vesicles and ejaculatory ducts. The testes are oval in the scrotum. The epididymis is actually a continuous part of the testicle. It is a semicircular body that attaches to the outside of the testicle and is divided into three parts: the head, the body and the tail. The vas deferens is a direct continuation of the tail of the epididymis. The total length is 30-40 cm, and the transverse diameter is 3 mm. It is emitted from the inner side of the epididymis and then up to the inguinal canal. Then it goes up along the inner side wall of the pelvic cavity, and then extends inward and down to the bottom of the bladder to reach the abdomen. The vas deferens continue to be the ejaculatory duct, which is open to the posterior urethra. The seminal vesicle is a small cystic organ located above the prostate between the bladder and the rectum, with the ampulla of the vas deferens on the inside. Basic Information Specialist classification: male examination inspection classification: X-ray Applicable gender: whether the male is fasting: not fasting Tips: Acute road inflammation and iodine allergy are prohibited. Those with testicular and epididymal inflammation or swelling are prohibited. Normal value (1) X-ray examination of seminal vesicles and vas deferens: Normal x-ray performance: The road system is symmetrical on both sides. Each side is divided into four parts: the vas deferens, the ampulla, the seminal vesicle and the ejaculatory duct. The vas deferens from the end of the epididymis, finally the ejaculatory duct, the full length of 30 ~ 40cm, in the scrotum with spermatic cord up to the inguinal canal, along the inner wall of the pelvic cavity to the bottom of the bladder, 4 ~ 6cm above the prostate into the ampulla. The lumen diameter is 2~3mm, and the ampulla is 3~4cm long. It is located above the bladder bottom and the seminal vesicle. The inner and lower parts are connected with the ejaculatory duct and seminal vesicle, and the diameter of the tube is irregularly twisted. The edges are serrated and bilaterally symmetrical. The seminal vesicle is a pair of spiral organs, which are located in the gap of the bladder rectum and are repeatedly folded by a 15 cm long pipe. After angiography, it has an inverted pear shape with a smooth outline and a meandering curve. The ejaculation tube is a narrow part of the end of the vas deferens, with a total length of 1 to 3 cm. It passes from the upper edge of the prostate to the prostatic body and opens to both sides of the urethra. The diameter of the pipe is 1.5 to 2 mm, the upper and the lower are thin, and the opening is only 0.5 mm. (2) X-ray examination of the scrotum: Normal x-ray performance: After the scrotum is injected into the contrast agent, the testicles are elliptical, one on each side, the left side is slightly lower than the right side, about 4 × 3 × 2 cm3, and the edges are clear and sharp. The epididymis is a half-moon shape attached to the posterior aspect of the testis, which is a continuous part of the testis. The upper end is swollen and obtuse to the head of the epididymis. The vas deferens is a continuation of the epididymis, starting from the tail of the epididymis and ending in the ejaculatory duct. There is a strip of fine lines above the head of the epididymis. (3) X-ray examination of the penis: Normal x-ray performance: The contrast agent fills the corpus cavernosum with uniform image density and smooth edges. Clinical significance Abnormal results: (1) X-ray examination of seminal vesicles and vas deferens: X-ray examination of seminal vesicles and vas deferens is mainly x-ray examination. It is used to observe the seminal vesicles, vas deferens and the ampulla and ejaculatory ducts. It is used to diagnose various diseases of the spermatic tract and also to identify prostate tumors and hypertrophy. (2) X-ray examination of the scrotum: The anatomy of the scrotum is superficial and easy to palpate. Generally, x-ray examination is not required. However, under special circumstances, angiography can directly understand the morphology of the testis, epididymis and spermatic cord and the relationship with spermatic cord. Contrasts have some pain and complications. Abnormal x-ray performance: (1) Chronic orchitis can be enlarged in both testis and epididymis, but the edges are smooth, there is no adhesion around, and there is no change in spermatic cord. (2) Testicular and epididymal tuberculosis The testicles are swollen, the edges are irregular, the testicles and epididymis are unclear, and if they adhere to the surrounding tissues, the sheath cavity is poorly filled. (3) The scrotum of the hydrocele is enlarged, and the contrast agent is diluted and the image is lightly diluted. (4) Testicular dysplasia or abnormalities can be found in both testes without development or testicles, epididymis and spermatic cords, shadow reduction, most bilateral occurrence at the same time, you can also find fusion testes. (3) X-ray examination of the penis: Abnormal X-ray performance: (1) Abnormal erection of the penis causes blood deposition due to thrombosis in the cavernous body. The contrast shows uneven density, irregular edges, and a small amount of contrast agent retention. (2) Penile induration is a fibrous induration of the cavernous body. The general lesion begins on the septum between the corpus cavernosum and forms irregular cords or nodules that can be concurrently present. During angiography, there is a filling defect in the sponge or a depression in the edge of the cavernous body. The septum is widened, and the contrast can confirm the location and extent of the lesion. People who need to check: (1) X-ray examination of seminal vesicles and vas deferens: (1) Identify the causes of male infertility. (2) Congenital malformations or chronic inflammation of the seminal vesicle. (3) Changes in the fine path caused by prostatic hypertrophy and other pathological changes. (2) X-ray examination of the scrotum: (I) Testicular chronic inflammation and tuberculosis patients. (2) spermatic cyst, hydrocele and varicocele. (3) Testicular atrophy and cryptorchidism patients. (3) X-ray examination of the penis: For abnormal penile erection and penile sclerosis. Precautions Taboo before inspection: Avoid receiving X-ray examination repeatedly in a short time. Requirements for inspection: 1. When the patient is in perspective, photo and various angiography, his family members and relatives and friends should not enter the examination room at will; if the patient needs to hold it, he can ask the staff to wear lead skirt and lead gloves to reduce unnecessary. Irradiation. 2, avoid excessive tension when doing X-ray examination. 3. Except for the inspection site, the rest are covered with lead rubber. Inspection process (1) X-ray examination of seminal vesicles and vas deferens: Contrast operation procedures and methods: (1) Contrast preparation: disinfect the external genital skin and drain the urine. Take a flat sheet to observe the presence or absence of calcification. (2) Contrast agent: 76% compound diatrizoate lOml (used after dilution). The person to be examined needs to do an iodine allergy test, and the test is negative and then the angiography is performed. (3) Operating procedures and methods: 1 by the vas deferens method: routine disinfection, after local anesthesia, open the scrotum, find the bilateral vas deferens, free vas deferens, slowly inject a little saline, such as large resistance, proved in the lumen, and then injected contrast agent 1.5-2ml on each side. At the time of injection, the inguinal part generally has a feeling of soreness. Contrast injection should not be too much, so as to avoid image overlap in the urethra and bladder. Immediately after the injection, the film was taken under fluoroscopy. 2 transurethral method: the application of special urethra mirror, F4 catheter inserted into the posterior urethra, looking for the ejaculatory duct opening in the vicinity of Jingjing, insert ejaculation tube 3-5cm, each side injection of contrast agent 3 ~ 4ml can be taken. The part of the film is flat with the bladder area. Because this method is difficult to operate and can cause tissue damage, it is not widely used in clinical practice. (2) X-ray examination of the scrotum: Operating procedures and methods: (1) Contrast preparation: clean the scrotum and empty the bladder. (2) Contrast agent: 10% diatrizoate (after dilution) 10 ~ 20ml, air 20 ~ 40ml. (3) Operating procedures: 1 contrast agent contrast: conventional disinfection puncture needle and local, injection of contrast agent 10 ~ 20ml, in order to reduce the stimulation, you can add 1% procaine a little in the contrast agent. 2 air angiography: routine disinfection, puncture from the scrotum suture to the right, injecting gas 20 ~ 40ml. If there is hydrocele, the fluid should be withdrawn and then inflated. The injected gas can be absorbed after one week. 3 Immediately after the injection of the contrast agent, take a picture. When taking the positive position, the patient is in a prone position, the legs are separated, the grid is not used, the photo is placed under the scrotum, and the center line is tilted 20o to 30O to the lateral position. The patient is lying on the side, the lower leg is flexed, and the upper leg is Straighten out, the photo is placed under the scrotum, and the center line is above the scrotum. When the oblique position is taken, the patient is lying on the side, the body is tilted 40O, the lower leg is bent, the upper leg is externally rotated, the photo is placed under the scrotum, and the center line is aligned with the scrotum. The selection of the above photographic position can also be performed under fluoroscopy and filming. (3) X-ray examination of the penis: The penis is mainly composed of two corpus cavernosum and one urethral cavernous body, which are located on the dorsal and ventral sides of the penis. This kind of angiographic examination is rarely used clinically. Contrast procedure and method: (1) Preparation before angiography: clean the penis and do an iodine allergy test. (2) contrast agent: 76% compound diatrizoate, diluted 10 ~ 20ml. (3) Operating procedures: 1 Inject 2.5% lidocaine into the proximal skin of the glans, anesthetize the fascia and the cavernous body, and then puncture the needle into the cavernous body of the penis. Inject a little saline first. If there is no local swelling, the needle tip is located in the sponge. 2 injection of contrast agent 10 ~ 20ml, the amount should not be too much, so as not to cover up the lesion, because the penis end of the compartment often has a gap, the two sides of the sponge body are connected to each other, so the injection side can be developed on both sides. To be fully charged. Not suitable for the crowd Inappropriate crowd: (A) X-ray examination of seminal vesicles and vas deferens: acute sperm road inflammation and iodine allergy are prohibited. (B) X-ray examination of the scrotum: The following patients are banned: (1) There are inflammation or swelling of the testis and epididymis. (2) Iodine allergies. (C) X-ray examination of the penis: penile inflammation and iodine allergy are prohibited. (4) Infants, young children, children and patients allergic to X-ray. Adverse reactions and risks Nothing.

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