高频超声对非性功能障碍男性不育患者阴囊疾病的诊断价值分析

Diagnostic Value of High Frequency Ultrasound in Scrotal Diseases in Male Infertility Patients with Non-sexual Dysfunction

目的探讨高频超声对非性功能障碍男性不育患者阴囊疾病的诊断价值。方法回顾性分析2014年1月—2016年1月北京大学第三医院的非性功能障碍男性不育症患者阴囊高频超声检查结果及图像特点,主要包括睾丸、附睾、输精管阴囊部、睾丸鞘膜腔及精索静脉的形态结构、内部回声及血流动力学等信息。结果共选择男性不育症患者1 645例,高频超声检查显示阴囊异常发生率为76.8%(1 264/1 645)。睾丸异常发生率为35.0%(575/1 645),包括睾丸体积小249例(15.1%)、睾丸实质回声不均匀95例(5.8%)等;附睾异常发生率为59.9%(986/1 645),包括附睾囊肿582例(35.4%)、附睾体积增大153例(9.3%)等;输精管阴囊部异常发生率为1.8%(29/1 645),包括输精管阴囊部增粗、扩张、狭窄、闭塞;睾丸鞘膜腔异常发生率为4.4%(73/1 645),包括睾丸鞘膜腔积液52例(3.2%)和睾丸鞘膜腔结石21例(1.3%);精索静脉曲张发生率为34.5%(567/1 645),包括左侧396例(24.1%)、双侧147例(8.9%)、右侧24例(1.5%)。结论高频超声可以清晰显示睾丸、附睾、输精管阴囊部、睾丸鞘膜腔和精索静脉正常及异常声像图,对男性不育者进行阴囊高频超声检查,有助于临床获得部分先天及后天影响男性不育的诊断和治疗依据。

Objective To investigate the diagnostic value of high frequency ultrasound in scrotal diseases in male infertility patients with non -sexual dysfunction. Methods The scrota1 high frequency ultrasound examination results and image characteristics of male infertility patients with non - sexual dysfunction in Peking University Third Hospital were retrospectively analyzed from January 2014 to January 2016, mainly including the morphology, internal echo, hemodynamics and other information of testis, epididymis, scrota1 part of vas deferens, testis vagina tunic cavity and spermatic vein. Results A total of 1 645 cases of male infertility were selected, and the abnormal rate was 76. 8% （1 264/1 645 ） by high frequency uhrasonography. The abnormal rate of testis was 35.0% （575/1 645） , including 249 cases （ 15.1% ） of small testis, 95 cases （5.8%） of heterogeneous testicular parenchyma echo, etc. The abnormal rate of epididymis was 59.9% （986/1 645 ）, including 582 cases （35.4%） of epididymal cyst, 153 cases （9.3%） of increased epididymis volume, etc. The abnormal rate of scrotal part of vas deferens was 1.8% （29/1 645） , including thickening, dilatation, stenosis and occlusion in vas deferens scrotum segment ; the abnormal rate of testis vagina tunic cavity was 4.4% （ 73/1 645 ）, including 52 cases （ 3.2% ） of hydrocele of tunica vaginalis and 21 cases （ 1.3% ） of lithiasis of tunica vaginalis; the rate of varicocele was 34. 5% （567/1 645）, including 396 cases （24. 1% ） on the left side, 147 cases （8.9%） on the bilateral sides, 24 cases （1.5%） on the right side. Conclusion The normal and abnormal sonogram of testis, epididymis and scrotal part of vas deferens, testis vagina tunic cavity and spermatic vein can be clearly demonstrated by the high frequency uhrasound. The scrotal high frequency ultrasonography examination in male infertility patients is helpful for clinical acquisition of diagnosis and treatment basis on some congenital and acquired diseases affecting on male sterility.