梗阻性无精子症经直肠B超声像表现及其临床意义

Sonographic Features and Clinical Significance of Transrectal Ultrasonography in Obstructive Azoospermia

目的:探讨梗阻性无精子症经直肠B超的声像表现及其在梗阻定位诊断中的应用价值。方法:对248例临床诊断为梗阻性无精子症的男性患者行经直肠B超检查,观察前列腺、双侧精囊及射精管的声像表现。结果:本组病例前列腺体积平均13.2 ml。前列腺、双侧精囊及射精管形态正常111例。双侧精囊缺如39例,双侧精囊发育不全33例,单侧精囊发育不全、对侧精囊缺如23例,双侧精囊扩张28例,单侧精囊扩张14例。这42例精囊扩张者中射精管扩张18例、前列腺中线部位囊肿17例。结论:梗阻性无精子症的病变类型多样。经直肠B超可以清楚显示前列腺、精囊及射精管的形态与病变,对于判断梗阻性无精子症的病变类型及部位有一定的参考作用。

Objective： To investigate the ultrasonographic features of obstructive azoospermia and to evaluate transrectal uhrasonography in the diagnosis of the disease. Methods ： We performed transrectal ultrasonography for 248 patients with obstructive azoospermia, observed the sonographic features of the prostate gland, seminal vesicle and ejaculatory duct. Results ： The average volume of the prostate gland of the studied group was 13.2 ml. A total of 111 cases showed normal sonographic features, 39 cases bilateral seminal vesicle defect, 33 cases bilateral seminal vesicle aplasia, 23 cases unilateral seminal vesicle defect and contralateral seminal vesicle aplasia, 28 cases bilateral and 14 cases unilateral seminal vesicle dilatation. Of the 42 cases of seminal vesicle dilatation, 18 had ejaculatory duct dilatation and 17 had cysts in the midline of the prostate. Conclusion ： Obstructive azoomspermia varies in kind. Transrectal untrasonography can reveal the details of the prostate, seminal vesicle and ejaculatory duct and help to classify obstructive azoospermia and determine the location of the lesion.