Demir Mehmet, Kazımoğlu Hatem
Harran University, Faculty of Medicine, Department of Radiology - Şanlıurfa, Turkey.
Sanko University Hospital, Faculty of Medicine, Department of Urology - Gaziantep, Turkey.
Rev Assoc Med Bras (1992). 2025 Jun 16;71(5):e20250074. doi: 10.1590/1806-9282.20250074. eCollection 2025.
Uncontrolled activation of immune cells, such as lymphocytes and macrophages, can result in heightened inflammatory cytokine production, leading to oxidative stress and cell death in various organs, including the brain and testes. The systemic effects of COVID-19 are not limited to the respiratory system and can also affect other organs. The aim of this study was to focus on the possible effects of COVID-19 infection on the testicles in male patients.
Ultrasound images of 50 patients who were shown to have COVID-19 infection by polymerase chain reaction method and 50 healthy volunteers who did not have any complaints and were polymerase chain reaction negative were evaluated retrospectively. While forming the patient and control groups, people who smoked or had diseases such as varicocele, which caused testicular parenchyma to be affected, were excluded from the study. Tissue histogram analysis was performed on the images obtained, including the entire testicular parenchyma, and radiomics were obtained. The Mann-Whitney U test and independent samples t-test were used to compare parametric and non-parametric results in independent groups.
The average age of the patient group and control group was 32.13±7.3 years and 31.23±7.9 years, respectively, and no statistically significant difference was detected (p>0.05). When testicular volumes in the patient and control groups were compared, no statistically significant difference was detected (p=0.58). Statistically significant differences were found between the two groups in the radiomics examined using skewness of histogram, zone-size non-uniformity of gray-level size-zone matrix, information measure of correlation of gray-level co-occurrence matrix, run percentage of gray-level run-length matrix, high gray-level run emphasis of gray-level run-length matrix, and kurtosis of histogram (p<0.05). There was no significant difference in other parameters.
Ultrasound histogram analysis may be useful in showing heterogeneity, which is an indicator of the impact on the testicular parenchyma in people with COVID-19 infection. Thus, in addition to other clinical findings and laboratory parameters, ultrasound histogram analysis may be helpful in demonstrating testicular parenchymal involvement in the follow-up of patients after COVID-19.
免疫细胞（如淋巴细胞和巨噬细胞）的失控激活会导致炎症细胞因子产生增加，进而在包括脑和睾丸在内的各个器官中引发氧化应激和细胞死亡。新冠病毒病（COVID-19）的全身影响不仅限于呼吸系统，还会影响其他器官。本研究的目的是聚焦于COVID-19感染对男性患者睾丸可能产生的影响。
回顾性评估50例经聚合酶链反应法证实感染COVID-19的患者及50例无任何不适且聚合酶链反应阴性的健康志愿者的超声图像。在形成患者组和对照组时，将吸烟或患有精索静脉曲张等导致睾丸实质受影响疾病的人排除在研究之外。对获取的包括整个睾丸实质的图像进行组织直方图分析，并获得放射组学数据。采用曼-惠特尼U检验和独立样本t检验比较独立组中的参数和非参数结果。
患者组和对照组的平均年龄分别为32.13±7.3岁和31.23±7.9岁，未检测到统计学显著差异（p>0.05）。比较患者组和对照组的睾丸体积时，未检测到统计学显著差异（p=0.58）。在使用直方图偏度、灰度大小区域矩阵的区域大小不均匀性、灰度共生矩阵的信息相关度量、灰度游程长度矩阵的游程百分比、灰度游程长度矩阵的高灰度游程强调以及直方图峰度进行检查的放射组学方面，两组之间存在统计学显著差异（p<0.05）。其他参数无显著差异。
超声直方图分析可能有助于显示异质性，而异质性是COVID-19感染者睾丸实质受影响的一个指标。因此，除其他临床发现和实验室参数外，超声直方图分析可能有助于在COVID-19患者随访中证明睾丸实质受累情况。
