Aliyev Ramil, Hekimsoy İlhan, Tamsel İpek, Ekizalioğlu Duygu Doğa, Kalemci Mustafa Serdar, Altay Barış
Division of Radiology, Medicana International İzmir Hospital, İzmir, Turkey.
Division of Radiology, İzmir Torbalı State Hospital, İzmir, Turkey.
J Ultrasound Med. 2024 Sep;43(9):1745-1754. doi: 10.1002/jum.16510. Epub 2024 Jun 12.
This study aimed to investigate the correlation between testicular shear wave elastography (SWE) values and semen analysis results in men with infertility.
This was a retrospective case-control study. Patients were categorized as normal, abnormal, or azoospermic based on sperm analysis results. Testicular volume was measured using B-mode ultrasonography using the Lambert formula. Subsequently, 40-80 regions of interest measuring 1.5 × 1.5 mm were manually positioned in both testicles based on their size, and two-dimensional SWE was applied through virtual touch imaging quantification software.
The patients had a mean age of 33.79 ± 6.3 years, with semen analysis revealing normal results in 15 patients (22.4%), pathological findings in 35 patients (52.2%), and azoospermia in 17 patients (25.4%). Right, left, total, and mean testicular volumes were significantly lower in patients with azoospermia compared to those in both normal and impaired semen parameters (P < .05). Conversely, testicular elastography scores were higher in patients with azoospermia than in the other groups (P < .05). The significant negative correlation between volume and elastographic findings remained independent of age (r = 0.4, P < .001). The accuracy rates for detecting impaired semen parameters and azoospermia were 94.3% and 94.1%, respectively, after considering factors such as age, testicular volume (right/left/total), and elastography (right/left/total). Notably, the total mean elastography score ranked first, with 100% in the independent normalized importance distribution of these variables.
SWE can be used effectively alone or in combination with other diagnostic tools to evaluate histopathological changes in the testicles of male patients with infertility.
本研究旨在探讨不育男性睾丸剪切波弹性成像（SWE）值与精液分析结果之间的相关性。
这是一项回顾性病例对照研究。根据精子分析结果，将患者分为正常、异常或无精子症三类。使用兰伯特公式通过B型超声测量睾丸体积。随后，根据睾丸大小在两侧睾丸中手动定位40 - 80个1.5×1.5毫米的感兴趣区域，并通过虚拟触诊成像定量软件应用二维SWE。
患者的平均年龄为33.79±6.3岁，精液分析显示15例患者（22.4%）结果正常，35例患者（52.2%）有病理结果，17例患者（25.4%）无精子症。与精液参数正常和受损的患者相比，无精子症患者的右侧、左侧、总体和平均睾丸体积显著更低（P < 0.05）。相反，无精子症患者的睾丸弹性成像评分高于其他组（P < 0.05）。体积与弹性成像结果之间的显著负相关在不考虑年龄的情况下仍然存在（r = 0.4，P < 0.001）。在考虑年龄、睾丸体积（右侧/左侧/总体）和弹性成像（右侧/左侧/总体）等因素后，检测精液参数受损和无精子症的准确率分别为94.3%和94.1%。值得注意的是，总平均弹性成像评分排名第一，在这些变量的独立标准化重要性分布中为100%。
SWE可单独或与其他诊断工具联合有效用于评估不育男性患者睾丸的组织病理学变化。
