Liang Rong-Xi, Xue En-Sheng, Lin Li-Wu, Yu Liang, Chen Shun, Yu Li-Yun, He Yi-Mi, Gao Shang-Da
Fujian Provincial Institute of Ultrasonic Medicine, Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China.
Zhonghua Nan Ke Xue. 2009 Feb;15(2):115-21.
To discuss the correlation between sonographic appearance of different degrees of acute unilateral testicular ischemia and histological changes of the testis after reperfusion.
Thirty-two male rabbits were equally divided into a control (sham operation) group and 3 ischemia groups. Unilateral testicular ischemia models were established under the color Doppler ultrasound (CDU) observation and allocated according to different degrees of ischemia to Group A (with homogeneous echoes and slightly decreased flow signals), B (with heterogeneous echoes and obviously decreased flow signals) and C (with radial or small-shredded low echoes and absence of flow signals). Then contrast-enhanced ultrasonography (CEUS) was performed, followed by reperfusion of the ischemic testes. A month later, the histological changes of the testes were observed and the correlation of the histological changes with the sonographic and CEUS manifestations was analyzed.
Concerning the CEUS parameters such as the arrival time (AT), reperfusion rate, time-to-peak (TTP), half descent time (DT/2) of the ischemic testes, Groups A and B showed significant differences from the control group (P < 0.05). The peak-base difference (PBD) was significant in Group B (P < 0.05) but not in A (P > 0.05), and no enhancement was seen in Group C. As for Johnson's scores obtained 1 month later, Group A exhibited no significant difference (8.70 +/- 0.39) (P > 0.05), Group B showed significant difference (6.01 +/- 0.88) (P < 0.05), and Group C extremely significant difference (3.16 +/- 1.05) (P< 0.001) from the control group (9.10 +/- 0.11).
CEUS is superior to CDU in evaluating the perfusion of testicular ischemia. Sonographic appearances of testicular ischemia are significantly correlated with histological changes of the testis after reperfusion. Ultrasonography helps to predict the spermatogenetic function of ischemic testes after reperfusion.
探讨不同程度急性单侧睾丸缺血的超声表现与再灌注后睾丸组织学变化之间的相关性。
将32只雄性兔平均分为对照组(假手术组)和3个缺血组。在彩色多普勒超声(CDU)观察下建立单侧睾丸缺血模型,并根据缺血程度分为A组(回声均匀,血流信号轻度减少)、B组(回声不均匀,血流信号明显减少)和C组(呈放射状或小片状低回声,无血流信号)。然后进行超声造影(CEUS),随后对缺血睾丸进行再灌注。1个月后,观察睾丸的组织学变化,并分析组织学变化与超声及CEUS表现的相关性。
关于缺血睾丸的超声造影参数,如达峰时间(AT)、再灌注率、峰值时间(TTP)、半降时间(DT/2),A组和B组与对照组有显著差异(P<0.05)。B组的峰底差(PBD)有显著差异(P<0.05),而A组无显著差异(P>0.05),C组无增强。至于1个月后获得的约翰逊评分,A组与对照组(9.10±0.11)无显著差异(8.70±0.39)(P>0.05),B组有显著差异(6.01±0.88)(P<0.05),C组与对照组有极显著差异(3.16±1.05)(P<0.001)。
在评估睾丸缺血灌注方面,CEUS优于CDU。睾丸缺血的超声表现与再灌注后睾丸的组织学变化显著相关。超声有助于预测再灌注后缺血睾丸的生精功能。