Gonda R L, Karo J J, Forte R A, O'Donnell K T
AJR Am J Roentgenol. 1987 Jan;148(1):71-5. doi: 10.2214/ajr.148.1.71.
The clinically obvious varicocele is perhaps the most common identifiable and correctable cause of male infertility. However, less is known about the subclinical (not palpable) varicocele and its relationship to infertility. We undertook this study to compare the ability of high-resolution sonography and radionuclide scrotal scanning to detect subclinical varicocele. Fifty patients who were referred to our department with a diagnosis of infertility, an abnormal semen analysis, and a normal physical examination of the scrotum underwent both sonography and nuclear scanning. The final study group included 20 men who agreed to surgical ligation of the spermatic vein(s) after a positive sonographic and/or radionuclide study. Sonography was considered positive for subclinical varicocele in 95% of patients, while nuclear scanning was considered positive in only 55%. Postoperatively, all patients showed improvement in their semen and 40% (eight patients) became fertile. Subclinical varicocele seems to be an important causal factor in infertility and, in our experience, high-resolution sonography is superior to radionuclide scanning in its diagnosis.
临床上明显的精索静脉曲张可能是男性不育最常见的可识别和可纠正原因。然而，关于亚临床（触诊不到）精索静脉曲张及其与不育的关系，人们了解较少。我们开展这项研究以比较高分辨率超声检查和放射性核素阴囊扫描检测亚临床精索静脉曲张的能力。50例因不育、精液分析异常且阴囊体格检查正常而转诊至我科的患者接受了超声检查和核扫描。最终研究组包括20名在超声检查和/或放射性核素检查呈阳性后同意进行精索静脉手术结扎的男性。超声检查在95%的患者中被认为亚临床精索静脉曲张呈阳性，而核扫描仅在55%的患者中被认为呈阳性。术后，所有患者的精液均有改善，40%（8例患者）恢复生育能力。亚临床精索静脉曲张似乎是不育的一个重要病因，根据我们的经验，高分辨率超声检查在诊断方面优于放射性核素扫描。
