实时超声弹性成像定量参数分析在无精子症鉴别诊断中的初步应用  

Quantitative analysis by real-time elastosonography for the differential diagnosis of azoospermia: Preliminary application

作　　者：李敏[1] 李凤华[1] 杜晶[1] 王之倩[1] 郑菊芬[2] 李铮[3] 平萍[3] 

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 [3]上海交通大学医学院附属仁济医院泌尿外科,上海200001

出　　处：《中华男科学杂志》2012年第1期35-38,共4页National Journal of Andrology

基　　金：上海市重点学科建设项目(S30203)~~

摘　　要：目的:探讨实时超声弹性成像定量参数分析在鉴别诊断梗阻性及非梗阻性无精子症中的价值。方法:分析200例梗阻性无精子症和300例非梗阻性无精子症患者及100例健康对照组的睾丸超声弹性图像,计算睾丸与周围阴囊表皮的应变比值,分别统计3组的比值中位数,并通过ROC曲线分析获得梗阻性及非梗阻性无精子症最合适的临界值。结果:非梗阻性无精子症的应变比值中位数为0.49±0.43,而梗阻性无精子症为0.35±0.31,两者差异有统计学意义(Z=-19.173,P<0.017)。通过ROC曲线分析,曲线下面积为0.857±0.012,取得最合适诊断临界点为0.395(敏感性=84.5%,特异性=74.5%,准确性=80.5%)。结论:实时超声弹性成像定量参数分析为梗阻性及非梗阻性无精子症的鉴别诊断提供了一种新的方法。Objective： To evaluate the quantitative analysis by real-time elastosonography in the differential diagnosis of obstructive azoospermia（OA） and non-obstructive azoospermia（NOA）.Methods： We evaluated the elastosonographic images of 200 cases of OA,300 cases of NOA and 100 normal healthy controls,calculated the strain ratio of the testis to the scrotal skin and the median strain ratio among the three groups,and analyzed the best cut-off point for differentiating OA and NOA by the receiver operation characteristic（ROC） curve.Results： The median strain ratio of NOA was 0.49±0.43,while that of OA was 0.35±0.31,with significant difference between the two groups（Z=-19.173,P=0.000〈0.017）.According to the results of ROC curve analysis,the area under the curve was 0.857±0.012 and the best cut-off point for differentiating OA and NOA was 0.395（sensitivity=84.5%,specificity=74.5%,accuracy=80.5%）.Conclusion： Quantitative analysis by real-time elastosonography is a new valuable technique for the differential diagnosis of azoospermia.

关 键 词：无精子症 实时超声弹性成像 鉴别诊断 

分 类 号：R698.2[医药卫生—泌尿科学]