经阴囊及经直肠超声对诊断先天性双侧输精管缺如价值的研究  

Value of Scrotal Ultrasonography and Transrectal Ultrasonography in the Diagnosis of Congenital Bilateral Absence of the Vas Deferens

作　　者：杨黎明[1] 李凤华[1] 杜晶[1] 李铮[2] 

机构地区：[1]上海交通大学医学院附属仁济医院超声科,上海200001 [2]上海交通大学医学院附属仁济医院泌尿科,上海200001

出　　处：《生殖与避孕》2008年第12期734-738,744,共6页Reproduction and Contraception

基　　金：浦东新区科技发展基金创新资金项目,项目编号:PKJ2007-Y18

摘　　要：目的:探讨超声检查在诊断先天性双侧输精管缺如(CBAVD)中的价值。方法:回顾性分析380例CBAVD经阴囊及经直肠超声声像图表现。结果:所有患者超声检查均出现异常声像图;其中376例的752只附睾出现超声声像图异常,异常比率为99%(752/760),包括附睾头回声杂乱伴扩张、附睾头单纯扩张、附睾体附睾管扩张、附睾体部缺失、附睾体截断征、附睾尾附睾管扩张、附睾尾部缺失;365例的706条输精管阴囊段出现声像图异常,异常比率为93%(706/760),包括双侧缺失、双侧截断征、双侧纤细、一侧正常对侧缺失、一侧截断征对侧缺失;335例患者的605条输精管末段声像图出现异常,异常比率为80%(605/760),包括双侧缺失、一侧正常对侧缺失、一侧截断征对侧缺失。369例726只精囊声像图异常,异常比率为96%(726/760),包括双侧缺失、一侧正常对侧缺失;一侧发育不良对侧缺失、双侧扩张、一侧精囊部位畸形结构对侧缺失。结论:经阴囊及直肠超声检查,可清楚显示CBAVD患者输精管道的各种发育异常结构,为CBAVD患者的临床诊治提供可靠的超声影像依据。Objective： To assess the value of ultrasonography in the diagnosis of congenital bilateral absence of the vas deferens （CBAVD）. Methods： The scrotal ultrasonography （US） and transrectal ultrasonography （TRUS） manifestations of 380 CBAVD patients were retrospectively analyzed, which mainly included epididymis, scrotal segments and last segments of vas deferens, and seminal vesicle. Results： All the ultrasonic probe patients presented abnormal sonogram： 752 epididymis of 376 cases presented abnormal sonogram, abnormality rate was 99% （752/760）, including epididymal heads presented uneven echo and tubular ectasia, epididymal heads presented tubular ectasia, epididymal bodys presented epididymal duct ectasia, epididymal bodys presented absent, epididymal bodys presented tapering, epididymal tails presented epididymal duct ectasia, epididymal tails presented absent; 706 scrotal segments of vas deferens of 365 cases presented abnormal sonogram, abnormality rate was 93% （706/760）, including bilateral absence, bilateral tapering, bilateral tenuity, unilateral normal and contralateral absence, unilateral tapering and contralateral absence; 605 last segments of vas deferens of 335 cases prerented abnormal sonogram, abnormality rate was 80% （605/760）, including bilateral absence, unilateral normal and contralateral absence, unilateral tapering and contralateral absence; 726 seminal vesicle of 369 cases presented abnormal sonogram, abnormality rate were 97% （726/760）, including bilateral absence, unilateral normal and contralateral absence, unilateral hypogenesis and contralateral absence, bilateral dilation, unilateral malformation structure in the position of seminal vesicle and contralateral absence. Conclusion： Scrotal US and TRUS can clearly display varieties of heteroplasia structures of deferential duct of CBAVD patient, and can provide credible sonogram evidence for diagnosis and treatment of the CBAVD patient.

关 键 词：先天性双侧输精管缺如(CBAVD) 经阴囊超声 经直肠超声 

分 类 号：R697.25[医药卫生—泌尿科学]