CT血管成像与彩色多普勒超声对精索静脉曲张诊断及其病因分析的对比研究

Comparison of CT angiography and color Doppler ultrasound in diagnosis and etiology screening of varicocele

目的探讨CTA与彩色多普勒超声在精索静脉曲张(VC)的诊断及其病因筛查中的价值。方法回顾性分析2016年5月至2017年12月中南大学湘雅医学院附属海口医院泌尿外科收治的97例临床诊断为VC患者的194条精索静脉(其中曲张精索静脉116条)的CTA与彩色多普勒超声影像资料,采用配对t检验比较CTA与彩色多普勒超声测量阴囊根部精索静脉的直径,采用McNemar检验比较CTA与彩色多普勒检查诊断VC的灵敏度和特异度,采用χ^(2)或Fisher确切概率法比较CTA与彩色多普勒在筛查引起VC病因的检出率。结果CTA与彩色多普勒超声检查测量116条曲张的精索静脉阴囊根部直径分别为(2.9±0.6)和(3.0±0.6)mm,差异无统计学意义(t=0.885,P=0.381)。以彩色多普勒超声检查诊断VC标准(直径>2 mm)为参考,CTA与彩色多普勒超声对VC的诊断灵敏度分别为95.69%(111/116)、100%(116/116),特异度均为100%(78/78),差异无统计学意义(P>0.05)。97例VC患者中CTA检查病因检出率明显高于彩色多普勒超声检查(P<0.05)。结论CTA和彩色多普勒超声对VC诊断均具有较高的灵敏度和特异度,CTA较彩色多普勒超声在VC病因筛检中具有更高的病因检出率。

Objective To investigate the values of CT angiography(CTA)and color Doppler ultrasound in the diagnosis and etiological screening of varicocele(VC).Methods Ninety-seven patients with VC diagnosed by the Department of Urology,Central South University Xiangya School of Medicine Affiliated Haikou Hospital from May 2016 to December 2017 were retrospectively included.The CTA and color Doppler ultrasonographic data of 194 spermatic veins(including 116 varicocele veins)were analyzed.Paired t test was used to compare the mean diameter of spermatic veins at the root of scrotum measured by CTA and color Doppler ultrasound.McNemar test was used to compare the sensitivity and specificity of CTA and color Doppler examination for VC,andχ^(2)or Fisher exact probability was used to compare the detection rate of CTA and color Doppler examination in screening the etiology of VC.Results The average diameters of scrotal root of spermatic veins by CTA and color Doppler ultrasonography were(2.9±0.6)and(3.0±0.6)mm for VC cases,with no significant difference found(t=0.885,P=0.381).According to the diagnostic VC standard of color Doppler ultrasound(diameter>2 mm),no significant difference was found between CTA and color Doppler ultrasound in the sensitivity[95.69%(111/116)vs.100%(116/116)]and specificity[100%(78/78)vs.100%(78/78)]in the diagnosis of VC.The etiological detection rate of CTA in 97 patients with VC was significantly higher than that of color Doppler ultrasound(P<0.05).Conclusions Both CTA and color Doppler ultrasound have high sensitivity and specificity in the diagnosis of VC.CTA has a higher etiological detection rate in etiological screening of VC than color Doppler ultrasound.