超声弹性检查对精索静脉曲张患者睾丸生精功能的评价价值  

Evaluation value of ultrasound elasticity test on the testicular spermatogenic function in patients with varicocele

作　　者：赵德威 王大亚 倪立董 黄求整 刘超 李镭钰 ZHAO Dewei;WANG Daya;NI Lidong;HUANG Qiuzheng;LIU Chao;LI Leiyu(Department of Urology,Wenzhou Central Hospital,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中心医院泌尿外科,浙江温州325000

出　　处：《中国性科学》2020年第5期16-18,共3页Chinese Journal of Human Sexuality

摘　　要：目的探讨超声弹性检查对精索静脉曲张(VC)患者睾丸生精功能的评价价值。方法选取2017年1月至2018年12月温州市中心医院诊治的96例VC患者作为研究对象。根据超声下精索静脉直径和反流程度分为VCⅠ级(仅在Valsalva试验时蔓状静脉丛出现反流且持续时间≥1s,1.8mm≤直径<2.4mm)34例,VCⅡ级(深呼吸时蔓状静脉丛出现反流,Valsalva试验反流加重,2.4mm≤直径<2.8mm)38例,VCⅢ级(平静呼吸时蔓状静脉丛出现反流,直径≥2.8mm)24例,并选择50例健康体检者(作为对照组),均应用声脉冲辐射力成像技术(ARFI)进行睾丸超声弹性检查获得弹性参数剪切波速度(Vs)值,并行精液常规检查获得精子质量相关参数。结果VC组左侧睾丸Vs值明显低于对照组(P<0.05),且随着超声分级提高,Vs值逐渐降低(P<0.05);且VCⅡ级组、VCⅢ级组右侧睾丸Vs值明显低于对照组(P<0.05)。VC组精子密度、精子存活率相比对照组明显较低(P<0.05),且随着超声分级提高,精子密度、精子存活率均逐渐降低(P<0.05)。Pearson相关分析显示,VC组睾丸组织Vs值与精子密度呈正相关(r=0.423,P<0.05),且与精子存活率亦呈正相关(r=0.589,P<0.05)。结论应用ARFI技术进行超声弹性检查获得的Vs值能够较好地反映睾丸质地改变,对于睾丸生精功能有重要评价价值。Objective To explore the evaluation value of ultrasound elasticity test on the testicular spermatogenic function in patients with varicocele(VC).Methods 96 patients with VC were selected,and according to the diameter of spermatic vein and the degree of reflux under ultrasound,they were divided into 34 cases of grade I VC(only in Valsalva test,pampiniform plexus showed reflux and lasted≥1 s,1.8 mm≤diameter<2.4 mm),38 cases of gradeⅡVC(in the deep breathing,pampiniform plexus showed reflux and Valsalva test showed aggravated reflux,2.4 mm≤diameter<2.8 mm)and 24 cases of gradeⅢVC(in eupnea,pampiniform plexus showed reflux,diameter≥2.8 mm),and 50 healthy subjects(control group)were selected.The acoustic radiation force impulse imaging(ARFI)was performed on subjects for testicular ultrasound elasticity test,and the elastic parameter shear wave velocity(Vs)value was obtained,and the sperm quality-related parameters were obtained by routine sperm examination.Results The Vs value of left testis in VC group was significantly lower than that in control group(P<0.05),and the Vs value was decreased gradually with the increase of ultrasound grading(P<0.05).The Vs values of right testes VCⅡgroup and VCⅢgroup were significantly lower than those in control group(P<0.05).The sperm density and sperm survival rate in VC group were significantly lower than those in control group(P<0.05),and the sperm density and sperm survival rate were decreased gradually with the increase of ultrasound grading(P<0.05).Pearson correlation analysis showed that the Vs value of testicular tissue in VC group was positively correlated with sperm density(r=0.423,P<0.05),and was also positively correlated with sperm survival rate(r=0.589,P<0.05).Conclusions The Vs value obtained by ARFI technique for ultrasound elasticity test can better reflect the testicular texture changes and has important evaluation value for testicular spermatogenic function.

关 键 词：精索静脉曲张 超声弹性成像 声脉冲辐射力成像技术 睾丸生精功能 

分 类 号：R697[医药卫生—泌尿科学]