经直肠彩色多普勒超声诊断梗阻性无精子症的价值

Value of transrectal color Doppler ultrasonography in diagnosis of obstructive azoospermia

目的探讨经直肠彩色多普勒超声(TRUS)在诊断梗阻性无精子症(OA)中的应用价值。方法回顾性分析159例经TRUS检查提示OA的不育症患者的图像资料,总结其图像特点,并分析不同部位、不同类型梗阻的超声诊断正确率。结果 TRUS发现159例患者中精路异常179处,最终确诊为OA 128例,TRUS诊断的总正确率为80.50%。TRUS诊断梗阻部位中以附睾(90.24%)及输精管(94.29%)梗阻诊断正确率较高,前列腺(60.71%)梗阻诊断正确率最低;梗阻类型中以因先天发育异常(97.37%)诊断正确率最高,炎症表现(68.09%)诊断正确率最低。结论 TRUS在OA的诊断中具有较高的应用价值,其诊断正确率在不同部位和不同梗阻类型中也不相同。

Objective To explore the application value of transrectal color Doppler ultrasonography（ TRUS） in the diagnosis of obstructive azoospermia（ OA）. Methods The image data of 159 infertile patients who had been examined by TRUS for OA were analyzed retrospectively. The image features were summarized,and the diagnostic accuracies of TRUS for different parts or different types of obstruction were analyzed. Results TRUS revealed that 159 patients had 179 abnormalities of the seminal tract,and 128 patients were diagnosed with OA. The total diagnostic accuracy of TRUS was 80. 5%. As for the obstruction parts,the diagnostic accuracy of TRUS for obstruction of epididymis（ 90. 24%） or vas deferens（ 94. 29%） was higher,and the diagnostic accuracy（ 60. 71%） for prostate obstruction was the lowest. As for the obstruction types,the highest diagnostic accuracy（ 97. 37%） of TRUS was observed in the cases of congenital dysplasia,and the lowest（ 68. 09%） in the cases of inflammation. Conclusion TRUS has a higher application value in the diagnosis of OA,and its diagnostic accuracy is different for various parts and various types of obstruction.