Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
J Urol. 2012 Nov;188(5):1861-6. doi: 10.1016/j.juro.2012.07.031. Epub 2012 Sep 19.
We evaluated the diagnostic performance of real-time elastography for differentiating nonobstructive from obstructive azoospermia.
We evaluated 1,192 testes, including 584 with nonobstructive azoospermia, 408 with obstructive azoospermia and 200 controls, from men with a mean ± SD age of 30 ± 5 years. Two radiologists evaluated the testes using a 5-degree elastography score system. The strain ratio was calculated on line. Of 156 azoospermic testes 78 were diagnosed by bilateral testicular biopsy for diagnostic purposes or sperm harvesting.
In our software system a score of 3 indicated average strain, and scores 4 and 5 indicated low strain. Average or low strain (score 3 to 5) was seen in 477 of 584 testes with nonobstructive azoospermia (81.7%). This rate was significantly higher than the rate in obstructive azoospermic and control testes (68 of 408 or 16.3% and 30 of 200 or 15.0%, p <0.001). The strain ratio significantly differed for nonobstructive and obstructive azoospermia (median 0.490 and 0.340, Z = -20.560, p <0.001).
Real-time elastography is a promising imaging method with great potential for the differential diagnosis of azoospermia.
我们评估实时弹性成像在鉴别非梗阻性与梗阻性无精子症中的诊断性能。
我们评估了 1192 例睾丸，包括 584 例非梗阻性无精子症、408 例梗阻性无精子症和 200 例对照，这些患者的平均年龄 ± SD 为 30 ± 5 岁。两位放射科医生使用 5 度弹性成像评分系统评估睾丸。在线计算应变比。在 156 例无精子症睾丸中，有 78 例因诊断目的或精子采集而行双侧睾丸活检。
在我们的软件系统中，3 分表示平均应变，4 分和 5 分表示低应变。在 584 例非梗阻性无精子症睾丸中，有 477 例（81.7%）表现为平均或低应变（评分 3 至 5）。这一比例明显高于梗阻性无精子症和对照组睾丸（408 例中为 68 例，占 16.3%；200 例中为 30 例，占 15.0%，p <0.001）。非梗阻性和梗阻性无精子症的应变比差异有统计学意义（中位数分别为 0.490 和 0.340，Z = -20.560，p <0.001）。
实时弹性成像作为一种有前途的成像方法，在无精子症的鉴别诊断中具有很大的潜力。
