| 李康宁.超声在梗阻性无精症患者治疗方式选择中的临床价值研究[J].中国医学影像技术,2020,36(4): |
| 超声在梗阻性无精症患者治疗方式选择中的临床价值研究 |
| Study on the clinical value of ultrasonography in the treatment of obstructive azoospermia |
| 投稿时间：2019-04-12 修订日期：2020-04-21 |
| DOI： |
| 中文关键词: 阴囊超声 梗阻性无精症 先天性输精管发育不良 取精术 输精管吻合术 |
| 英文关键词:Scrotal ultrasonography Obstructive azoospermia Congenital absence of the vas deferens Sperm extraction Vasovasostomy |
| 基金项目:无 |
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| 中文摘要: |
| 目的：探讨超声在梗阻性无精症患者治疗方式选择中的临床价值。
方法：前瞻性收集93例梗阻性无精症患者，行阴囊超声检查观察附睾、输精管是否完整可见、扩张及钙化，测量扩张附睾管及输精管内径。根据后续的治疗方式分成：取精组和重建组。比较两组患者的病因及超声征象是否存在差异。采用ROC曲线评价有统计学差异的超声参数在筛选梗阻性无精症患者治疗方式的临界值、敏感性、特异度、阳性预测值、阴性预测值及准确性。
结果：本研究纳入27例取精组和66例重建组。附睾形态异常、输精管细小或缺失、钙化及附睾管内径在两组间存在统计学差异（P＜0.05）；两组间睾丸体积及输精管内径差异无统计学意义（P＞0.05）。以附睾管内径0.55mm作为临界值，诊断的敏感性87.5%，特异度86.7%，阳性预测值77.8%，阴性预测值92.8%，准确性87.0%。
结论：阴囊超声检查在梗阻性无精症患者治疗方式的选择指导上具有重要临床意义，推荐超声发现附睾管内径＞0.55mm，附睾形态异常，输精管细小或缺失，输精管或附睾管钙化等时，采用精子抽吸术。 |
| 英文摘要: |
| Objective: To explore the clinical value of ultrasonography in the treatment of obstructive azoospermia.
Methods: Ninety-three patients with azoospermia were prospectively collected. Scrotal ultrasound was performed to observe whether the epididymis and vas deferens were intact, dilated or calcified. The diameter of epididymal duct and vas deferens were measured. The cases were divided into two groups according to the treatment: sperm extraction group and vasal reconstruction group. The etiology and sonographic appearances were compared between the two groups. The cut-off value of ultrasonic parameters were evaluated by the ROC curve, followed by the accuracy, sensitivity, specificity, positive predicative value and negative predicative value.
Results: Sixty-six cases of sperm extraction group and twenty-seven cases of vasal reconstruction group were enrolled in our study. There were significant differences between the two groups in epididymal morphology, vas deferens dysplasia, calcification, and the diameter of epididymal duct(P＜0.05). The testicular volume and vas deferens diameter were not significant different between the two groups(P＞0.05). If 0.55mm for the diameter of epididymal duct was taken as the cut-off value, the accuracy of correctly identifying the patients suitable for sperm extraction was 87.5%, with the sensitivity, specificity, positive predictive value and negative predictive value being 86%, 90.9%, 74.1%, 89.6% and 76.9% respectively.
Conclusion: Scrotal ultrasonography plays an important role in guiding treatment for patients with obstructive azoospermia. |
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