分析腹股沟直疝疝囊进入阴囊的CT表现。

回顾性分析2018年1月至2024年4月永康市第一人民医院及永康市中医院收住入院的腹股沟直疝疝囊进入阴囊的13例患者的临床及CT影像资料。观察CT图像并记录疝囊位置、腹壁下动静脉显示情况及与疝囊颈关系、侧新月征、疝囊最大层面直径、疝囊进入阴囊深度。

所有患者疝囊均跨越耻骨结节十字交叉法以耻骨结节前外缘作为标志点做Y轴（垂直线），所有患者腹壁下动静脉均可以显示，疝囊颈均位于腹壁下动静脉内侧，显示侧新月征患者9例，疝囊最大层面直径44.0~64.5 mm，平均（52.2±5.4）mm，3例疝囊下极达到睾丸水平，疝囊下极位于睾丸以上水平患者10例。

疝囊进入阴囊的腹股沟直疝容易误诊为斜疝，腹壁下动静脉与疝囊颈的位置关系及侧新月征为两者的鉴别关键点，Delabrousse的十字交叉法不能用于疝囊进入阴囊的腹股沟疝鉴别。

To conduct analysis of the CT manifestations of direct inguinal hernias with hernia sac entering the scrotum.

Retrospective analysis of clinical and CT imaging data of 13 patients with inguinal hernia sac entering the scrotum admitted to Yongkang First People's Hospital and Yongkang Hospital of Traditional Chinese Medicine from January 2018 to April 2024. Retrospective analysis of clinical and CT imaging data from 13 cases of direct inguinal hernias with hernia sac entering the scrotum. CT images were examined to record the position of the hernia sac, the display of inferior epigastric arteries and veins, and their relationship with the hernia sac neck, the lateral crescent sign presence, the hernia sac maximum cross-sectional diameter, and the depth of the hernia sac entering the scrotum.

All patients' hernia sacs were crossed over the pubic tubercle using the cross method, with the anterior outer edge of the pubic tubercle as the marker point for the Y-axis (vertical line). In all cases, the inferior epigastric arteries and veins were visible. the neck of the hernia sac was located on the inner side of the inferior epigastric arteries and veins. The lateral crescent sign was observed in 9 cases. The maximum cross-sectional diameter of the hernia sac ranged from 44.0 to 64.5 mm, with an average of (52.2±5.4) mm. In three case, the lower pole of the hernia sac reached the level of the testicle, while in ten cases, it was located above the level of the testicle.

Direct inguinal hernias with hernia sac entering the scrotum can be easily misdiagnosed as indirect inguinal hernias. The relationship between the inferior epigastric arteries and veins and the hernia sac neck, along with the presence of the lateral crescent sign, are key points for differentiation. Delabrousse E's "cross" crossmethod is not suitable for distinguishing inguinal hernias with hernia sac entering the scrotum.