梗阻性无精子症附睾超声声像图特征研究  

Ultrasonographic features of epididymides in obstructive azoospermia

作　　者：王之倩[1] 李凤华[1] 杜晶[1] 郑菊芬[2] 

机构地区：[1]上海交通大学医学院附属仁济医院超声医学科,上海200001 [2]上海交通大学医学院附属仁济医院生殖医学科,上海200001

出　　处：《中华男科学杂志》2010年第11期984-989,共6页National Journal of Andrology

基　　金：上海市重点学科建设项目(S30203);浦东新区科技发展创新基金(PKJ2007-Y18)~~

摘　　要：目的:探讨先天性及后天获得性梗阻性无精子症附睾超声声像图的特征性改变。方法:应用经阴囊超声观察和评估211例梗阻性无精子症患者附睾的异常声像图改变,比较先天性(n=118)及后天获得性梗阻性无精子症(n=93)附睾超声声像图特征的差异。结果:先天性梗阻性无精子症附睾头部回声杂乱伴输出小管扩张、体尾部缺如、体尾部条索样改变、体尾部截断征百分率高于后天获得性梗阻性无精子症,差异有统计学意义(P<0.05)。后天获得性梗阻性无精子症附睾体尾部附睾管细网状扩张、附睾尾炎性团块百分率高于先天性梗阻性无精子症,两者差异有统计学意义(P<0.01)。先天性梗阻性无精子症附睾头、体、尾附睾管状扩张百分率分别为:5.9%(14/236)、17.2%(41/236)、8.4%(20/236),高于后天获得性梗阻性无精子症(P<0.05),后天获得性梗阻性无精子症附睾头、体、尾附睾管细网状扩张的百分率分别为:64.0%(119/186)、76.3%(142/186)、58.6%(109/186),高于先天性梗阻性无精子症(P<0.05)。先天性梗阻性无精子症附睾主要特征为附睾管不规则扩张伴管壁回声减弱且结构欠清(P<0.05),后天性梗阻性无精子症附睾管则呈规则扩张伴管壁回声增强(P<0.01)。结论:先天性及后天获得性梗阻性无精子症附睾超声声像图特征存在明显不同,对于两者鉴别有很大的临床实用价值。Objective：To investigate the ultrasonographic features of epididymides in congenital obstructive azoospermia（COA）and acquired obstructive azoospermia（AOA）.Methods：A total of 211 infertile men with obstructive azoospermia were observed by scrotal ultrasonography,and the features of the epididymal ultrasonograms were compared between COA and AOA.Results：COA exhibited significantly higher rates of ectasia in the epididymal head,cord-like changes,abrupt tapering and absence of the epididymal body and tail than AOA（P 0.05）,while AOA showed markedly higher rates of epididymal body and tail duct ectasia and epididymal inflammatory mass than COA（P 0.01）.Tubular ectasia of the epididymal duct in the head,body and tail were markedly higher in the COA（14 [5.9%],41 [17.2%] and 20 [8.4%] cases in 236 epididymides）than in the AOA（P0.05）.Retiform ectasia were markedly higher in the AOA（119 [64.0%],142 [76.3%] and 109 [58.6%] cases in 186 epididymides）than in the COA（P0.05）,with statistically significant differences between the two groups（P 0.05）.Ultrasonographically,the epididymides of the COA patients were characterized by irregular ectasia of the epididymal tube with decreased and unclear wall echoes（P 0.05）,and those of the AOA patients by regular ectasia with enhanced wall echoes（P 0.01）.Conclusion：The ultrasonographic epididymal features of COA are obviously different from those of AOA,which is of important clinical application value for distinguishing the two conditions from each other.

关 键 词：先天性梗阻性无精子症 后天获得性梗阻性无精子症 附睾异常超声声像图 

分 类 号：R698.2[医药卫生—泌尿科学]