摘要
目的探讨高频彩色多普勒与超声弹性成像技术对精索静脉曲张(varicocele,VC)患者术后生育力的评估价值。方法选取2017年6月~2021年6月本院行腹腔镜精索静脉结扎术的72例VC患者纳入VC组,根据超声分级方法分为A组(Ⅰ级)21例,B组(Ⅱ级)34例,C组(Ⅲ级)17例。选取72例同期于本院行健康体检并排除各种影响生育力因素的正常男性纳入对照组。分别于对照组体检当日和VC组术前1 d、术后1月,采用彩色多普勒超声仪检查两组精索静脉平静呼吸时最大内径(spermatic vein diameter at rest,DR)、Valsalva试验时最大内径(diameter at Valsalva maneuver,DV)、最高反流流速(spermatic vein maximum velocity,VS-Vmax)和静脉反流时间(reflux time,TR),采用弹性成像模式获取应变均(MEAN)值、蓝色区域所占百分比(AREA);采用酶联免疫法检测抑制素B(inhibin B,InhB)水平,全自动免疫分析仪检测血清FSH(follicle stimulating hormone,卵泡刺激素)水平;分别于术前和术后1月,检测VC组精子总数、精子密度及精子存活率;Pearson检验VC组术后超声弹性成像参数和超声血流参数与患者精子质量的相关性。结果术前A、B、C组VC患者DR、DV、VS-Vmax、MEAN值及FSH水平均明显升高,AREA值及InhB水平降低;不同VC超声分级VC患者DR、DV、VS-Vmax、MEAN值、AREA值和InhB、FSH水平差异显著(P<0.05);VC组术后MEAN值、DR、DV、VS-Vmax、TR等超声血流参数与精子总数、精子密度和精子活动度呈负相关(P<0.05),AREA值与精子总数、精子密度和精子活动度等精子质量相关指标呈正相关。结论VC患者术后高频彩色多普勒超声与超声弹性成像参数均显著降低,高频彩色多普勒超声与超声弹性成像均可作为VC患者术后疗效的可靠的评估指标。
Objective To evaluate the value of high-frequency color Doppler and ultrasonic elastography in assessing the fertility of patients with varicocele(VC)after operation.Methods On the day of physical examination in the control group and one day before and one month after the operation in the VC group,the maximum respiratory diameter(DR),the maximum diameter(DV),the maximum velocity(vs Vmax)and the venous reflux time(TR)of the spermatic vein in the two groups were examined by color Doppler ultrasound,The mean strain(mean)value and the percentage of blue area(area)were obtained by elastic imaging mode;Inhibin B(inhb)level was detected by enzyme-linked immunosorbent assay(ELISA),and serum FSH(follicular stimulating hormone)level was detected by automatic immune analyzer;The total number of sperm,sperm density and sperm survival rate in VC group were measured before and 1 month after operation;Pearson examined the correlation between the postoperative ultrasound elastography parameters and ultrasound blood flow parameters and sperm quality in VC group.Results Compared with the control group,the levels of DR,DV,vs Vmax,mean,area and FSH in patients with VC in groups a,B and C increased before operation,while the level of inhb decreased(P<0.05);The levels of DR,DV,vs Vmax,mean,area,inhb and FSH in VC patients with different ultrasonic grades were significantly different(P<0.05);Dr,DV,vs Vmax,TR,mean and area in VC group were significantly lower than those before operation(P<0.05);The total sperm count,sperm density and sperm motility in VC group were significantly higher than those before operation(P<0.05);Mean,area,Dr,DV,vs Vmax and TR in VC group were positively correlated with total sperm count,sperm density and sperm motility(P<0.05).Conclusion The parameters of high-frequency color Doppler ultrasound and ultrasonic elastography were significantly decreased in patients with VC after operation.Both high-frequency color Doppler ultrasound and ultrasonic elastography can.
作者
杨会
余晓梅
郭敬东
戴旭辉
Yang Hui;Yu Xiaomei;Guo Jingdong;Dai Xuhui(Department of Ultrasound,Wuhan NO.1 Hospital,Wuhan 430022,Hubei,China)
出处
《中国男科学杂志》
CAS
CSCD
2022年第5期63-67,72,共6页
Chinese Journal of Andrology
关键词
高频彩色多普勒超声
超声弹性成像
精索静脉曲张
术后生育力
精液质量
high frequency color Doppler ultrasound
ultrasonic elastography
varicocele
postoperative fertility
semen quality
