剪切波弹性成像联合超声造影对睾丸生精功能的检测价值

Detection value of shear wave elastography combined with contrast-enhanced ultrasound on testicular spermatogenic function

目的探讨剪切波弹性成像(SWE)联合超声造影对睾丸生精功能的评估作用。方法选取广州市番禺区中心医院2022年1月至12月收治的50例无精患者纳入无精组,50例弱精患者纳入少弱精组,另选取同期到院体检的正常健康男性100例作为对照组。三组均进行SWE和超声造影检查,比较各组间的弹性模量平均值(Emean)及各超声造影参数差异,并采用ROC曲线分析Emean及各超声造影参数对睾丸生精功能异常的预测效能。结果无精组的Emean、起始增强时间(AT)、达峰时间(TTP)高于少弱精组、对照组,峰值强度(PI)低于少弱精组、对照组,差异有统计学意义(P<0.05)。ROC曲线分析显示,Emean、AT、TTP、PI及上述指标联合检测对睾丸生精功能异常均有预测价值(P<0.05),其中联合检测的预测价值最高,其AUC为0.887,敏感度为74.00%,特异度为94.55%。结论SWE技术和超声造影均对睾丸生精功能有预测价值,且二者联合对睾丸生精功能异常的预测价值更高。

Objective To explore the evaluated effect of shear wave elastography(SWE)combined with contrast-enhanced ultrasound on testicular spermatogenic function.Methods Fifty patients with anspermia treated in Guangzhou Panyu Central Hospital from January to December 2022 were included in the anspermia group,and 50 patients with asthenospermia were enrolled as asthenospermia group,and 100 normal healthy males who came to the hospital for physical examination during the same period were collected as control group.SWE and contrast-enhanced ultrasound were performed in all three groups to compare the mean elastic modulus(Emean)and the difference of each contrast-enhanced ultrasound parameter among all groups,and ROC curve was used to analyze the prediction efficiency of Emean and each contrast-enhanced ultrasound parameter on testicular spermatogenic dysfunction.Results The Emean,arriving time(AT)and time to peak(TTP)in anspermia group were higher than those in asthenospermia group and control group,and the peak intensity(PI)was lower than that in asthenospermia group and control group,the differences were statistically significant(P<0.05).ROC curve analysis showed that the combined detection of Emean,AT,TTP,PI and the above indexes had predictive value for testicular spermatogenic dysfunction(P<0.05),among which the combined detection had the highest predictive value,with AUC of 0.887,sensitivity of 74.00%and specificity of 94.55%.Conclusion Both SWE and contrast-enhanced ultrasound have predictive value on testicular spermatogenic function,and their combination has a higher predictive value on testicular spermatogenic function abnormality.