剪切波弹性成像技术判断睾丸生精功能  

Shear wave elastography for judging testicular spermatogenesis

作　　者：李田 伍拓[2] 左辉兰 杨舒婷 高峰[1] LI Tian;WU Tuo;ZUO Huilan;YANG Shuting;GAO Feng(Department of Ultrasound,the Third Xiangya Hospital of Central South University,Changsha 410013,China;Department of Urology,the Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院超声科,湖南长沙410013 [2]中南大学湘雅三医院泌尿外科,湖南长沙410013

出　　处：《中国医学影像技术》2020年第10期1508-1511,共4页Chinese Journal of Medical Imaging Technology

基　　金：湖南省自然科学基金面上项目(2018JJ2604)。

摘　　要：目的探讨剪切波弹性成像技术能否判断睾丸生精功能受损严重程度。方法纳入38例无精患者(无精组)和34例少弱精患者(少弱精组),另选33名精液正常者为对照组。比较各组间睾丸体积(TV)、睾丸剪切波速度(SWV)及SWV极差的差异。绘制受试者工作特性(ROC)曲线,评估SWV及SWV极差的诊断效能。结果无精组TV明显低于其余2组(P均<0.05);少弱精组与对照组差异无统计学意义(P>0.05)。3组患者年龄差异均无统计学意义(P均>0.05)。无精组SWV及SWV极差显著高于其余2组(P均<0.05),少弱精组与对照组差异无统计学意义(P>0.05)。TV<10 ml睾丸的SWV明显高于TV≥10 ml者(P<0.05)。SWV与TV呈低度负相关(r=-0.42,P<0.05)。SWV极差与TV呈弱相关(r=-0.19,P>0.05)。依据无精组与对照组SWV及SWV极差值建立ROC曲线,SWV截断值为1.73 m/s时,AUC为0.84,敏感度为89.41%、特异度为76.53%。SWV极差为1.54 m/s时,AUC为0.75,敏感度和特异度分别为68.10%和73.03%。结论SWV测量睾丸组织硬度用于评估睾丸生精功能严重受损具有较高临床价值。Objective To explore whether shear wave elastography could be used to judge the severity of testicular spermatogenic damage.Methods A total of 38 patients with azoospermia(azoospermia group)and 34 patients with oligospermia(oligospermia group)were included,while 33 normal semen subjects were selected as controls(control group).The differences of testicular volume(TV),testicular shear wave velocity(SWV)and SWV heterogeneity were compared among groups.The receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficiency of SWV and SWV heterogeneity.Results TV in azoospermia group was significantly lower than that in the other 2 groups(both P<0.05),and no significant difference of TV between oligospermia group and control group(P>0.05).No statistically significant difference of age was found among 3 groups.SWV and SWV heterogeneity in azoospermia group were both significantly higher than those in the other 2 groups(both P<0.05),and no significant difference of SWV nor SWV heterogeneity was detected between oligospermia group and control group(P>0.05).SWV of TV<10 ml testes were significantly higher than that of testes with TV≥10 ml(P<0.05).SWV was negatively correlated with TV(r=-0.42,P<0.05).SWV heterogeneity was weakly correlated with TV(r=-0.19,P>0.05).The ROC curve was established based on SWV and SWV heterogeneity values of azoospermia group and control group.Taken 1.73 m/s as the critical value of SWV,the AUC was 0.84,the sensitivity was 89.41%,and the specificity was 76.53%.When SWV heterogeneity was 1.54 m/s and AUC was 0.75,the sensitivity and specificity was 68.10%and 73.03%,respectively.Conclusion Measuring the hardness of testicular tissue with SWV showed good clinical value in assessment of severely impaired testicular spermatogenesis.

关 键 词：睾丸 精子发生 弹性成像技术 

分 类 号：R697.2[医药卫生—泌尿科学] R445.1[医药卫生—外科学]