Haddad William T, Moritsugu Otavio Takashi, Fornazari Vitor Rodrigues, Neto Carlos Alberto Ferreira Coelho, da Frota Yoram Balderrama, Molina Carlos Augusto Fernandes, Elias Jorge, Pazin-Filho Antonio, Muglia Valdair Francisco
Radiology Section, Hospital Clinicas, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes 3900, Campus Monte Alegre, 14090-900 Ribeirao Preto, Brazil.
Department of Surgery and Anatomy, Urology Division, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.
AJR Am J Roentgenol. 2020 Dec;215(6):1398-1402. doi: 10.2214/AJR.19.22672. Epub 2020 Oct 6.
The purpose of this study was to describe the prevalence of vas deferens (VD) calcifications on abdominal CT examinations and the associations between VD calcifications and several systemic conditions. The CT examinations of male patients from January 2010 to December 2011 were retrospectively reviewed. After exclusions, the records of 1915 consecutively identified patients were analyzed. Five readers, 3rd- and 4th-year radiology residents, recorded the presence and laterality of VD calcifications and of vascular calcifications presumed due to atherosclerosis. A sixth reader parsed the patient records for diagnoses of type 2 diabetes mellitus (DM) and chronic kidney disease (CKD). The mean age of the entire sample population was 52.9 ± 18.9 years (range, 1-93 years). The mean age of patients with VD calcifications was 59.3 ± 12.0 (SD) years and of the group without VD calcifications was 52.9 ± 19.1 years ( = 0.17). The prevalence of VD calcification was 1.61% (31 patients): 21 (67.7%) of the patients had bilateral calcification; seven (22.6%), right-sided only; and three, (9.7%) left-sided. The frequency of DM was 28.8% (551/1915), of CKD was 7.58% (150/1915), and of atherosclerosis, 60.4% (1156/1915). The mean caliber of calcified VDs was 5.31 ± 1.29 mm versus 3.63 ± 0.63 mm for patients without calcification or any chronic condition ( < 0.0001). Among age, atherosclerosis, DM, and CKD in univariate regression analysis, only DM was associated with VD calcification ( = 0.006). However, because age ( = 0.063) and atherosclerosis ( = 0.057) were close to significant, they were included in the multivariate analysis, which also showed only DM associated with VD calcification (odds ratio, 2.14 ± 0.85). In the large cohort in this study, the prevalence of VD calcification was 1.61%. VD calcification was strongly associated with DM. The pathologic implications of VD calcification remain unclear and warrant further investigation in prospective longitudinal studies.
本研究的目的是描述腹部CT检查中输精管（VD）钙化的患病率，以及VD钙化与几种全身性疾病之间的关联。对2010年1月至2011年12月男性患者的CT检查进行回顾性分析。排除相关病例后，对连续确诊的1915例患者的记录进行分析。5名阅片者（放射科住院医师3年级和4年级）记录VD钙化以及推测由动脉粥样硬化引起的血管钙化的存在情况及部位。第6名阅片者分析患者记录以诊断2型糖尿病（DM）和慢性肾脏病（CKD）。整个样本总体的平均年龄为52.9±18.9岁（范围1 - 93岁）。有VD钙化患者的平均年龄为59.3±12.0（标准差）岁，无VD钙化组的平均年龄为52.9±19.1岁（P = 0.17）。VD钙化的患病率为1.61%（31例患者）：21例（67.7%）患者双侧钙化；7例（22.6%）仅右侧钙化；3例（9.7%）左侧钙化。DM的发生率为28.8%（551/1915），CKD为7.58%（150/1915），动脉粥样硬化为60.4%（1156/1915）。钙化VD的平均管径为5.31±1.29mm，无钙化或任何慢性病患者的VD平均管径为3.63±0.63mm（P < 0.0001）。在单因素回归分析中，年龄、动脉粥样硬化、DM和CKD中，仅DM与VD钙化相关（P = 0.006）。然而，由于年龄（P = 0.063）和动脉粥样硬化（P = 0.057）接近具有统计学意义，故将它们纳入多因素分析，结果也显示仅DM与VD钙化相关（比值比，2.14±0.85）。在本研究的大样本队列中VD钙化的患病率为1.61%。VD钙化与DM密切相关。VD钙化的病理意义尚不清楚，值得在前瞻性纵向研究中进一步探究。
