Kocakoc Ercan, Serhatlioglu Selami, Kiris Adem, Bozgeyik Zulkif, Ozdemir Huseyin, Bodakci M Nuri
Department of Radiology, Faculty of Medicine, Firat University, Elazig, Turkey.
Eur J Radiol. 2003 Sep;47(3):251-6. doi: 10.1016/s0720-048x(02)00182-1.
Reflux is an important criterion for the diagnosis of varicoceles and in the existence of reflux more than 1 s is the lower limit for the diagnosis of varicoceles. We proposed to assess the relationship of vein diameters with the incidence, duration and flow volume of reflux using color Doppler sonography (CDS) in patients with clinically diagnosed varicocele.
Forty-seven patients with varicocele (aged 16-43) were included into the study. Reflux was assessed in spectral analysis using CDS and the duration, velocity and flow volume were measured.
Mean duration of reflux on right side was 1.5 +/- 0.3 s in 14 patients, throughout the Valsalva's maneuver in eight patients and no reflux in 25 patients. Mean duration of reflux on the left side was 1.5 +/- 0.3 s in 25 patients, throughout the Valsalva's maneuver in 18 patients and no reflux in four patients. The incidence of reflux in the testicular veins with a diameter lower than 3 mm was 62.3% whereas 94.4% in veins more than 3 mm in diameter. Flow volume of reflux was less than 10 ml/min in four patients and 21.7 +/- 24.3 ml/min in 18 patients on right side. Four patients had flow volume of reflux less than 10 ml/min and 39 patients had 27.9 +/- 35.6 ml/min on the left side. Flow volume meaningfully rose with increasing in vein diameter (r=0.83 on right; r=0.65 on left, P<0.01).
Measurement of flow volume of reflux has been considered as a more valuable method with respect to presence of reflux and/or measurement of venous diameter since flow volume reflects a combination of the vein diameters, duration and velocity of reflux.
反流是精索静脉曲张诊断的重要标准，反流时间超过1秒是精索静脉曲张诊断的下限。我们建议使用彩色多普勒超声（CDS）评估临床诊断为精索静脉曲张患者的静脉直径与反流发生率、持续时间和流量的关系。
47例精索静脉曲张患者（年龄16 - 43岁）纳入研究。使用CDS进行频谱分析评估反流情况，并测量反流持续时间、速度和流量。
14例右侧反流平均持续时间为1.5±0.3秒，8例在整个瓦尔萨尔瓦动作过程中存在反流，25例无反流。25例左侧反流平均持续时间为1.5±0.3秒，18例在整个瓦尔萨尔瓦动作过程中存在反流，4例无反流。直径小于3mm的睾丸静脉反流发生率为62.3%，而直径大于3mm的静脉反流发生率为94.4%。右侧4例患者反流流量小于10ml/min，18例患者反流流量为21.7±24.3ml/min。左侧4例患者反流流量小于10ml/min，39例患者反流流量为27.9±35.6ml/min。反流流量随静脉直径增加而显著增加（右侧r = 0.83；左侧r = 0.65，P < 0.01）。
由于反流流量反映了静脉直径、反流持续时间和速度的综合情况，因此相对于反流的存在和/或静脉直径测量，反流流量测量被认为是一种更有价值的方法。
