Luciani L, Bosetti S, Failoni G L, Menichelli E, Nicolini M, Peterlongo P, Taddei L
Diagn Imaging Clin Med. 1984;53(3):149-57.
From March 1977 to December 1982, 142 patients with varicocele of various sizes underwent preoperative antegrade or retrograde phlebography of the left spermatic vein. In 8 of them both procedures were carried out. A retrospective analysis of 68 preoperative antegrade venographies in supine (0 degree) and upright (30 degrees, 45 degrees and 90 degrees) positions was made and compared with 66 retrograde venograms. The preoperative 'dynamic' antegrade phlebography has been performed in order to study the hemodynamic conditions of the varicocele, avoiding any pressure interference on the valvular function of the venous renospermatic area. This technique has allowed us to get useful anatomoradiological and physiopathological information about the spontaneous reflux into the internal spermatic vein by its positional filling and emptying. It has also permitted a good visualization of collateral channels, particularly in the pelvic, femorosaphenous and scrotal areas. We could, at the same time, simultaneously sample blood from the cubital and intrascrotal spermatic veins to determine the testosterone, cortisol and serotonin levels, in different positions; the evaluation of these biochemical data is being pursued. In our opinion, this diagnostic procedure is easy to perform and inexpensive. The procedure and the results are discussed in detail.
1977年3月至1982年12月，142例不同程度精索静脉曲张患者接受了术前左侧精索静脉顺行或逆行静脉造影。其中8例患者两种检查都进行了。对68例术前仰卧位（0度）和直立位（30度、45度和90度）的顺行静脉造影进行回顾性分析，并与66例逆行静脉造影进行比较。术前进行“动态”顺行静脉造影是为了研究精索静脉曲张的血流动力学状况，避免对肾精索静脉区域瓣膜功能产生任何压力干扰。该技术使我们能够通过其位置性充盈和排空获得有关精索内静脉自发反流的有用解剖放射学和生理病理学信息。它还能很好地显示侧支通道，尤其是在盆腔、股隐静脉和阴囊区域。同时，我们可以在不同体位从肘静脉和阴囊内精索静脉采集血液样本，以测定睾酮、皮质醇和血清素水平；目前正在对这些生化数据进行评估。我们认为，这种诊断方法操作简便且成本低廉。将详细讨论该检查方法及结果。
