| 引用本文： |
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张兵,王秀艳.剪切波弹性成像技术评估男性不育患者少弱精症程度的价值分析[J].同济大学学报（医学版）,2020,41(3):368-372,377. [点击复制]
- ZHANG Bing,WANG Xiu-yan.Evaluation of oligospermia and asthenospermia in infertile men by shear wave elastography[J].同济大学学报（医学版）,2020,41(3):368-372,377. [点击复制]
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| 摘要: |
| 目的评价男性不育患者睾丸弹性模量与少弱精症程度的关系，探讨剪切波弹性成像（shear wave elastography, SWE）技术在无创评价少弱精症程度中的价值。方法选取少弱精症患者150例，通过精液分析分为轻度、中度、重度3组，其中68例患者因诊断及治疗行睾丸穿刺病理检查，并根据病理表现将患者生精功能分为生精正常、轻度生精减少、中度生精减少、重度生精减少4个类型，选取健康男性150例为对照组。用SWE技术检测各组的睾丸弹性模量，用高频超声测量睾丸的体积，分析不同程度少弱精症患者睾丸弹弹性模量及体积的差异，评价少弱精症程度与各参数的相关性，计算各参数诊断少弱精症的受试者特征曲线（ROC），获得无创评价少弱精症程度的最佳参数，分析其检测效能。将SWE检查结果与病理结果相对照，分析不同生精功能少弱精症患者睾丸弹性模量的差异。结果重度少弱精症组睾丸弹性模量最大值（Emax）、平均值（Emean）与对照组及轻-中度少弱精症组比较，差异均有统计学意义（P<0.05）；重度生精减少组睾丸的Emax、Emean与轻-中度生精减少组、生精正常组比较，差异有统计学意义（P<0.05）；睾丸弹性模量与少弱精症程度有显著相关性（r=0.518，P=0.000），其相关系数高于睾丸体积。睾丸Emax为4.10 kPa时，Roc曲线下面积（AUC）为0.80，其诊断重度少弱精症患者的灵感度为73.8%，特异度为81.2%，准确率为77.6%。结论睾丸弹性模量与少弱精症程度相关，在无创评价男性不育患者少弱精症程度上有一定的临床价值。 |
| 关键词: 剪切波弹性成像技术 少弱精症 睾丸 |
| DOI：10.16118/j.1008-0392.2020.03.018 |
| 投稿时间：2019-11-18 |
| 基金项目: |
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| Evaluation of oligospermia and asthenospermia in infertile men by shear wave elastography |
| ZHANG Bing,WANG Xiu-yan |
| (Dept. of Ultrasonic Diagnosis, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China) |
| Abstract: |
| ObjectiveTo evaluate the relationship between the testicular elastic modulus and the degree of oligospermia in male infertility patients, and to explore the value of shear wave elastography(SWE) in noninvasive evaluation of oligospermia and asthenospermia. MethodsOne hundred and fifty patients aged 20-45 years with oligospermia and asthenospermia and 150 age-matched healthy men(control group) were enrolled in the study. Patients were divided into three groups by semen analysis： mild group(n=40), moderate group(n=45) and severe group(n=65). Among them, 68 patients underwent testicular biopsy for diagnosis and treatment. According to the pathological features, the spermatogenic function of the patients was divided into four types： normal spermatogenesis, mild oligospermia, moderate oligospermia and severe oligospermia. The elastic modulus of testis was examined by SWE, the volume of testes was measured by high frequency ultrasound. The differences of elastic modulus and volume of testes in different degrees of oligospermia and asthenospermia were analyzed, and the correlation between the degree of oligospermia and each parameter was evaluated. The ROC of each parameter for diagnosing oligospermia and asthenospermia was generated, and the best parameter for noninvasive evaluation of oligospermia and asthenospermia was obtained. The difference of testicular elastic modulus between the patients with oligospermia and asthenospermia was analyzed. ResultsThere were significant differences in Emax and Emean between the severe oligospermia group and the control group(P<0.05); between severe oligospermia group and mild moderate oligospermia group, between severe oligospermia group and normal spermatogenesis group(P<0.05). The testicular elastic modulus was correlated with the degree of oligospermia(r=0.518, P=0.000), and the correlation coefficient was higher than that with the testicular volume. The area under the ROC(AUC) of Emax for diagnosis of severe oligospermia and asthenospermia was 0.80; when the cutoff value of Emax=4.10 kpa, the sensitivity, specificity and accuracy were 73.8%, 81.2% and 77.6%, respectively. ConclusionThe elastic modulus of testis is related to the degree of oligospermia, which has a certain clinical value in non-invasive evaluation of the degree of oligospermia in male infertility patients. |
| Key words: shear wave elastography oligoasthenospermia testis |
