Salbas Ali, Büyüktoka Raşit Eren
Department of Radiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35150, Turkey.
Department of Radiology, Foca State Hospital, Izmir 35680, Turkey.
Diagnostics (Basel). 2025 Aug 26;15(17):2150. doi: 10.3390/diagnostics15172150.
: A varicocele is a common, treatable cause of male infertility involving testicular alterations. Shear wave elastography (SWE) is a noninvasive imaging technique that may detect testicular changes. This study aimed to assess the testicular volume and stiffness (using SWE), compare them with healthy controls, and examine the associations with venous diameter and semen parameters. : This prospective comparative study included 69 patients with a varicocele and 76 healthy controls. The testicular stiffness and volume were measured and compared among three groups: testes with a varicocele (Group A), contralateral healthy testes of the same patients (Group B), and testes of healthy individuals (Group C). In varicocele patients, the semen analysis results were compared with testicular stiffness and volume. The statistical analyses included an ANOVA, Kruskal-Wallis tests, a correlation analysis, and a receiver operating characteristic curve analysis. : Group A showed a significantly lower testicular volume compared to Group B ( = 0.004) and Group C ( < 0.001), and significantly higher SWE values compared to both groups ( < 0.001). No significant differences were observed between Group B and Group C (volume: = 0.642; SWE: = 0.094). In oligospermic varicocele patients, the testicular stiffness tended to be higher, though the difference was not significant ( = 0.051). The correlations between the testicular stiffness and volume (Group A: = 0.488; Group B: = 0.872; Group C: = 0.222), between the venous diameter and stiffness ( = 0.067), and between the venous diameter and testicular volume ( = 0.245) were not statistically significant. The SWE cut-off value of 9.26 kPa provided a sensitivity of 73.1% (95% CI: 62.3-81.7%) and a specificity of 79.6% (95% CI: 72.5-85.2%) for identifying varicoceles. : Varicoceles are associated with an increased testicular stiffness and a decreased volume, which may indicate possible structural parenchymal alterations. Shear wave elastography appeared to be capable of noninvasively detecting these changes and may have potential as a quantitative adjunct tool for evaluating testicular parenchymal changes in varicocele patients. However, further studies are required to validate these preliminary findings.
精索静脉曲张是男性不育的常见可治疗病因，涉及睾丸改变。剪切波弹性成像（SWE）是一种可检测睾丸变化的非侵入性成像技术。本研究旨在评估睾丸体积和硬度（使用SWE），将其与健康对照进行比较，并研究其与静脉直径和精液参数的关联。
这项前瞻性比较研究纳入了69例精索静脉曲张患者和76例健康对照。测量并比较了三组的睾丸硬度和体积：患有精索静脉曲张的睾丸（A组）、同一患者的对侧健康睾丸（B组）以及健康个体的睾丸（C组）。对于精索静脉曲张患者，将精液分析结果与睾丸硬度和体积进行比较。统计分析包括方差分析、Kruskal-Wallis检验、相关性分析和受试者工作特征曲线分析。
A组的睾丸体积显著低于B组（P = 0.004）和C组（P < 0.001），且与两组相比，A组的SWE值显著更高（P < 0.001）。B组和C组之间未观察到显著差异（体积：P = 0.642；SWE：P = 0.094）。在少精子症的精索静脉曲张患者中，睾丸硬度倾向于更高，尽管差异不显著（P = 0.051）。睾丸硬度与体积之间（A组：P = 0.488；B组：P = 0.872；C组：P = 0.222）、静脉直径与硬度之间（P = 0.067）以及静脉直径与睾丸体积之间（P = 0.245）的相关性均无统计学意义。SWE临界值为9.26 kPa时，识别精索静脉曲张的灵敏度为73.1%（95%CI：62.3 - 81.7%），特异度为79.6%（95%CI：72.5 - 85.2%）。
精索静脉曲张与睾丸硬度增加和体积减小有关，这可能表明实质结构发生了改变。剪切波弹性成像似乎能够非侵入性地检测到这些变化，并且可能作为评估精索静脉曲张患者睾丸实质变化的定量辅助工具具有潜力。然而，需要进一步研究来验证这些初步发现。
