Research on acoustic radiation force impulse imaging in quantitative assessment of testicular stiffness in non-sterility varicocele patients

doi:10.16150/j.1671-2870.2019.05.011

Abstract

Abstract:

Objective: To investigate the correlation between the change of testicular tissue stiffness and the semen quality of non-sterility left varicocele(VC) patients by using acoustic radiation force impulse imaging(ARFI). Methods: According to the results of palpation and ultrasonic examination,143 cases of non-sterility left varicocele(VC) patients were divided into subclinical varicocele(SVC) group(42 cases), grade VC1 group (33 cases), grade VC2 group (49 cases),grade VC3 group (19 cases); in addition, 67 cases of normal subjects were served as controls.All subjects underwent semen examination and routine ultrasound examination. The shear wave velocity (SWV) in testis of all subjects were determined by acoustic pulse radiation imaging. The rank-sum test was used to compare the difference of SWV values and sperm quality between VC groups and control group. Pearson correlation analysis was used to analyze the correlation between sperm density, testicular volume, internal diameter of varicose veins and SWV in VC patients. Results: Compared with the control group, SWV value of testis decreased in VC group and VC2, VC3 group(Z_vc-CG=-5.015, Z_vc2-CG=-7.841, Z_vc3-CG=-6.182, P<0.01), sperm density decreased in the VC group and VC2, VC3 groups(Z_vc-CG=-6.878,Z_vc2-CG=-8.258,Z_vc3-XG=-8.695, P<0.01). Compared with the SVC group, SWV value of testis decreased in VC2, VC3 groups (Z_vc2-svc=6.674, Z_vc3-svc=5.557, P<0.01), sperm density decreased in VC2, VC3 group(Z_vc2-svc=6.407, Z_vc3-svc=7.432, P<0.01). Compared with VC1 group, SWV value of testis decreased in VC2, VC3 groups (Z_vc2-vc1=6.480, Z_vc3-vc1=5.529, P<0.01), sperm density in VC2, VC3 groups also decreased (Z_vc2-vc1=4.471, Z_vc3-vc1=5.953, P<0.01). Pearson correlation analysis showed that there was a positive correlation between SWV value and sperm density and testicular volume in VC group（r_left=0.732,r_right=0.664, P<0.01; r_left=0.595,r_right=0.417, P<0.01）. And there was a negative correlation between SWV value and internal diameter of spermatic vein（r_left=-0.758, r_right=-0.775, P<0.01）. Conclusions: The SWV value of testis can be used as a reference index to evaluate the change of testicular tissue stiffness and testicular spermatogenesis in VC patients.

Key words: Varicocele, Acoustic radation force impulse imaging, Shear wave velocity, Testis volume, Semen quality

CLC Number:

R445.1

LI Min, LIU Jun, WANG Zhiqian, ZHAN Weiwei. Research on acoustic radiation force impulse imaging in quantitative assessment of testicular stiffness in non-sterility varicocele patients[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(05): 543-547.

Figures/Tables 2

References 17

[1]	Bignulin S, Falleti E, Cmet S, et al. Usefulness of acoustic radiation force impulse and fibrotest in liver fibrosis assessment after liver transplant[J]. Ann Hepatol, 2016, 15(2):200-206. doi: 10.5604/16652681.1193710 pmid: 26845597
[2]	Liu BJ, Lu F, Xu HX, et al. The diagnosis value of acoustic radiation force impulse (ARFI) elastography for thyroid malignancy without highly suspicious features on conventional ultrasound[J]. Int J Clin Exp Med, 2015, 8(9):15362-15372.
[3]	邓芸, 刘若川, 朱尚勇, 等. 精索静脉曲张不育患者睾丸动脉彩超表现及精液质量相关性分析[J]. 中国超声医学杂志, 2010, 26(4):343-345.
[4]	Sakamoto H, Saito K, Oohta M, et al. Testicular volume measurement: comparison of ultrasonography, orchidometry, and water displacement[J]. Urology, 2007, 69(1):152-157. pmid: 17270639
[5]	D'Anastasi M, Schneevoigt BS, Trottmann M, et al. Acoustic radiation force impulse imaging of the testes: a preliminary experience[J]. Clin Hemorheol Microcirc, 2011, 49(1-4):105-114. doi: 10.3233/CH-2011-1461 URL
[6]	初洪钢, 郭瑞强, 孙彬, 等. 高频超声在诊断精索静脉曲张中的应用[J]. 中华超声影像学杂志, 2005, 14(3):215-217.
[7]	Wang H, Lv Y, Hu K, et al. Seminal plasma leptin and spermatozoon apoptosis in patients with varicocele and leucocytospermia[J]. Andrologia, 2015, 47(6):655-661. doi: 10.1111/and.12313 pmid: 25081128
[8]	Casey JT, Misseri R. Adolescent Varicoceles and Inferti-lity[J]. Endocrinol Metab Clin North Am, 2015, 44(4):835-842. doi: 10.1016/j.ecl.2015.07.007 URL
[9]	姜春峰, 宋亚林, 冯敏, 等. 精索静脉曲张致睾丸微循环损伤的彩超表现及治疗前后彩超对比观察[J]. 中国超声医学杂志, 2009, 25(4):410-413.
[10]	Yasim A, Resim S, Sahinkanat T, et al. Clinical and subclinical varicocele incidence in patients with primary varicose veins requiring surgery[J]. Ann Vasc Surg, 2013, 27(6):758-761. doi: 10.1016/j.avsg.2012.07.031 URL
[11]	张一峰, 徐辉雄, 刘畅, 等. 声触诊组织定量技术诊断结节性甲状腺肿的初步研究[J/CD]. 中华医学超声杂志:电子版, 2012, 9(5):448-451.
[12]	Rubaltelli L, Corradin S, Dorigo A, et al. Differential diag-nosis of benign and malignant thyroid nodules at elastosonography[J]. Ultraschall Med, 2009, 30(2):175-179. doi: 10.1055/s-2008-1027442 pmid: 18496776
[13]	柴启亮, 金佳美, 张忠云, 等. 声脉冲辐射力成像对精索静脉曲张不育患者睾丸的弹性定量研究[J]. 中国超声医学杂志, 2016, 32(9):826-829.
[14]	李会霞, 申志扬, 高新选, 等. 精索静脉曲张不育患者睾丸组织弹性成像表现及精液质量相关性分析[J/OL]. 中华临床医师杂志(电子版), 2013, 7(5):1890-1892.
[15]	李敏, 李风华, 杜晶, 等. 实时超声弹性成像评估无精子症睾丸生精功能的初步研究[J]. 中国超声医学杂志, 2012, 28(2):163-166.
[16]	张圣熙, 张耘, 宋旭, 龚敏, 等. 精索巨大脂肪瘤1例诊治报告[J]. 安徽医学, 2018, 39(8):1024-1025.
[17]	Du J, Li FH, Guo YF, et al. Differential diagnosis of azoospermia and etiologic classification of obstructive azoospermia: role of scrotal and transrectal US[J]. Radiolo-gy, 2010, 256(2):493-503.

组别	例数（n）	SWV值		精子密度（×10⁶/mL）
组别	例数（n）	右侧	左侧	精子密度（×10⁶/mL）
对照组	67	0.73±0.08	0.75±0.10	77.00±12.00
VC组	143	0.69±0.14^a)	0.68±0.16^a)	61.00±22.00^a)
SVC组	42	0.76±0.08	0.75±0.10	75.50±13.00
VC1组	33	0.75±0.10	0.76±0.07	70.00±16.00
VC2组	49	0.62±0.08^a),b),c)	0.62±0.07^a),b),c)	53.00±17.00^a),b),c)
VC3组	19	0.58±0.12^a),b),c)	0.57±0.11^a),b),c)	25.00±10.00^a),b),c)