彩色多普勒高频超声对精索静脉曲张不育者的诊断价值

目的探讨精索静脉曲张不育症患者彩色多普勒超声的诊断价值。方法用彩色多普勒超声观测38例精索静脉曲张不育患者的精索静脉内径和血液反流持续时间,结合精液质量评估患者的生育能力。结果 (1)患侧精索静脉内径增宽,血液反流。(2)精索静脉的内径与生育力指数呈负相关。结论做为精索静脉血流动力学改变的参数,彩色多普勒超声可提供管腔结构。结合精液检查,有助于评估精索静脉曲张患者的生育力损害程度。     

不育症亚临床型精索静脉曲张的诊断与治疗

目的：探讨不育症患者亚临床型精索静脉曲张的诊断与治疗。方法;采用彩色多普勒诊断亚临床型精索静脉曲张致不育症３２例。并且２ｍｍ针形腹腔镜行精索静脉高位结扎术。结果：所有患者术后恢复顺利,无伤口感染及睾丸肿胀或萎缩术后复查彩色多普勒示手术彻底,未见术后复发或反流。２１例获和１年随访。１６例患者本偶受孕。结论：彩色多普勒能准确诊断亚临床型精索静脉曲张,针形腹腔镜精索静脉高位结扎术是治疗此类患者的较好方法     

彩色多普勒对亚临床型精索静脉曲张不育患者的诊断价值

目的:探讨彩色多普勒(CDFI)对亚临床型精索静脉曲张(SVC)不育患者的诊断价值。方法:采用CDFI检测56例精液异常不育患者的精索静脉,观察蔓状静脉血管内径及血液返流时间,并行X线选择性精索内静脉造影对照分析。结果:平静状态下蔓状静脉内径为(2.24±0.16)mm;Valsalva运动时内径为(2.67±0.26)mm;返流时间为(1 487±203.66)m s,CDFI检测SVC的准确性为92.8%。结论:在男性不育的病因筛选中,CDFI检测对SVC的诊断比临床型精索静脉曲张更有意义。     

彩色多普勒超声在诊断精索静脉曲张中的临床应用

目的探讨彩色多普勒超声在诊断精索静脉曲张（VC）中的临床应用价值。方法回顾性分析103例VC患者的超声声像图表现,重点观察精索静脉内径及血流方向。结果 103例患者中,VC发生于左侧96例（96/103,93.20%）,右侧2例（2/103,1.94%）,双侧5例（5/103,4.85%）。超声检测亚临床型VC 21例（21/103,20.39%）,临床型VCⅠ级26例（26/103,25.24%）,Ⅱ级34例（34/103,33.01%）,Ⅲ级22例（22/103,21.36%）。103例VC患者中,58例接受手术治疗,超声诊断与手术结果符合率达100%（58/58）。结论彩色多普勒超声可准确诊断VC,为临床诊断和治疗VC提供可靠信息,具有重要临床应用价值。     

亚临床精索静脉曲张的诊治体会

对７５例体检正常的男性不育患者行高分辨彩色多普勒血流显像（ＣＤＦＩ）检查，发现亚临床精索静脉曲张（ＳＣＶ）４０例，其中左侧者２６例（６５％），双侧者１４例（３５％），行精索静脉高位结扎术３３例，行经皮精索胸脉栓塞术７例，术后３５例获得６个月随访，结果显示术后精子密度，精子活动率及正常形态精子率均明显改善，认为ＣＤＦＩ是诊断ＳＣＶ的一种简便，可靠的方法，其治疗应依据患者具有情况而定。     

睾丸微结石与精索静脉曲张(附42例报告)

目的 探讨睾丸微结石与精索静脉曲张的关系.方法 总结42例睾丸微结石患者临床资料.结果 双侧睾丸微结石(TM)40例,单侧2例,TM伴精索静脉曲张(VC),其中左VC40例,双VC2例.42例VC患者行精素内静脉离位结扎术.术后6个月38例TM伴不育者精子密度,a+b级精子和精子活率改善率分别为28.5%、41.6%和45.7%,3例妊娠(7.9%),术后0.5～2年睾丸微结石无变化.VC合并TM的患者,术后精子质量的改善率明显低于单纯VC术后.结论 VC可能是引起TM的病因之一.

Abstract：

Objectives To study the correlation between testicular microlithiasis and varicooele. Methods 42 cases of testicular microlithiasis were summarized and discused. Results 40cases of bilateral TM and 2 cases of unilateral TM. All the patients were performed withvaricocelectomy. The sperm concentration, percentage of after operation ,while 3 patients'wives were pregnant. Testicular microlithiasis didnt progress in half- two years after operation. The postoperative imprcvement ratio of sperm quality in varicocele patients with TM is lower than it in the patients with varicocele. Conclusions VC may be one of TM causes.     

超声诊断精索静脉曲张与男性不育相关性研究

精索静脉曲张(VC)是男性不育的常见原因之一.彩色多普勒超声诊断VC是极其敏感而且可以量化的影像学检查手段.我院1999年5月～2002年11月通过多普勒超声对41例男性不育患者、35例一般男性人群检查有无VC,并结合精液检查进行评价分析,旨在探讨VC与男性不育的诊断价值,为其诊断、治疗提供依据.     

三项检查诊断精索静脉曲张的比较研究

目的：评价体格检查（PE）、彩色多普勒超声（CDUS）和放射性核素阴囊闪烁显像术（RSS）诊断精索静脉曲张（VC）的价值。方法：对有男性不育一年以上病史且精液分析异常的138例行PE、CDUS及RSS检查。最终诊断依据CDUS、RSS检查结果结合精索静脉造影及随访结果得出的结论而定。三项检查结果与最终诊断作比较。结果：三项检查的灵敏度分别为70．3％、96．9％、93,8％,特异度分别为68,9％、93,2％、95,9％。结论：CDUS与RSS的灵敏度、特异度相近．均高于PE。RSS是一种非侵袭性,更加客观、准确的诊断VC的方法。     

高频超声在精索静脉曲张的诊断中的价值

精索静脉曲张(varicocele VC)是男性不育的常见原因,单纯依靠临床病史及触诊进行诊断,常缺乏准确的客观标准.为此,我们对临床拟诊为VC的35例患者行二维超声及彩色多普勒血流显像检查,以探讨二维超声及CDFI对VC的诊断价值,以期对临床治疗提供更多的帮助.     

红外热像诊断精索静脉曲张及其临床意义

目的 :探讨精索静脉曲张所致阴囊温度的变化及意义。　方法 :对 16 6例精索静脉曲张病人红外热像检查结果进行分析 ,配合彩超检查 ,其中 ,对 10 6例病人进行手术前后红外热像图及精液分析。　结果 :精索静脉曲张病人手术前后红外热像差异有极显著性 (P <0 .0 1) ,精液分析差异有极显著性 (P <0 .0 1;部分指标P <0 .0 5 )。结论 :红外热像检查配合精液分析及彩超检查对判断精索静脉曲张病人的诊断和治疗效果有一定意义。     

Significant predictive factors for subfertility in patients with subclinical varicocele

We made a retrospective study to determine useful parameters for predicting subfertility in patients with subclinical varicocele (SV). One hundred and fifty men with SV and 17 age‐matched men without SV were divided into three groups: Group 1, subfertile patients (n = 15); Group 2, fertile patients (n = 135); and Group 3, control patients (n = 17). Their age, body mass index (BMI), semen analysis, scrotal temperature, testicular volume, resistive index (RI), pulsatility index (PI) and peak retrograde flow (PRF) were compared. Subfertile patients (Group 1) with SV had significantly lower testicular volume and higher scrotal temperature, RI, PI and PRF than fertile men with SV (Group 2) and the control group (Group 3). Elderly men (>50 years, n = 30) with SV had a significantly higher incidence of bilateral SV than young men with SV (10/30; 33.3% vs. 12/120; 10%). There was no difference in age and BMI among the three groups. Patients with SV and RI >0.55 ml/s, PI >0.99 ml/s, total testicular volume <27 cc, scrotal temperature >34.9°C and PRF >29 cm/s have higher incidence of subfertility. Patients with SV may suffer from subfertility regardless of age. Close follow‐up with colour Doppler ultrasound may be beneficial.     

Intratesticular varicocele: evaluation using grey scale and color Doppler ultrasound

Intratesticular varicocele is a rare condition with a variable clinical and ultrasound presentation. The purpose of this study was to evaluate the grey scale and color Doppler appearances of intratesticular varicocele (ITV). Herein we present seven new cases of intratesticular varicocele. From 2003 to 2005 we evaluated 342 patients referred to our department for routine andrological evaluation by scrotal color Doppler ultrasound. We detected seven entirely asymptomatic cases of ITV by use of grey scale ultrasound. In color Doppler sonography the patients showed retrograde blood flow, either spontaneously or during Valsalva manoeuvre. In all seven cases left side ITV with testicular volume disproportion between the right and left testis (2 ml) was found. Five patients had an extratesticular varicocele. In all patients the diameters of intratesticular vein were less than 2 mm. Intratesticular varicocele is a clinically occult lesion that may occur in association with extratesticular varicocele. Further investigations are needed to clarify its clinical significance, however, considering the temperature mediated damage on the affected testis, it is our opinion that all ITV must be considered for treatment even if an extratesticular varicocele is not present.     

高频彩色多普勒超声对睾丸扭转的诊断价值

目的 探讨高频彩色多普勒超声对睾丸扭转的诊断价值.方法 对经手术证实的32例睾丸扭转患者的超声诊断结果及其彩色多普勒声像图特点进行回顾性分析.结果 超声首诊符合31例,诊断符合率96.88%.二维超声和彩色多普勒血流成像相结合,有助于对睾丸扭转的正确诊断.结论 高频彩色多普勒超声对睾丸扭转的诊断具有重要价值.     

彩色多普勒超声对无肾积水型输尿管结石的诊断价值

目的探讨彩色多普勒超声在无肾盂积水输尿管结石诊断中的价值。方珐结合利尿法,对反复肾绞痛、血尿、超声检查无肾盂积水的58例患者的各段输尿管进行多角度、多体位的追踪检查。结杲58例患者中,结石位于膀胱壁内段狭窄部48例,腹段4例,盆段1例,诊断符合率91．4％。结论结合利尿法,彩色多普勒超声在诊断无肾盂积水型输尿管结石中具有重要的临床价值。     

The role of color Doppler ultrasound in prediction of the outcome of microsurgical subinguinal varicocelectomy

PURPOSE: Overdiagnosis and undertreatment of varicocele may be responsible for the poor outcome of varicocelectomy. In this study we used color Doppler ultrasound for accurate diagnosis and grading of varicocele, and for predicting the outcome of microsurgical subinguinal varicocelectomy. MATERIALS AND METHODS: A total of 104 patients undergoing microsurgical subinguinal varicocelectomy for treatment of infertility were included in this study. Patients were evaluated with routine history, physical examination, semen analysis, hormonal assessment and scrotal ultrasound, and Doppler. After varicocelectomy improvement index in sperm concentration was calculated by dividing the difference between the postoperative and preoperative sperm concentration by the preoperative sperm concentration. Improvement index greater than 0.5 is considered a good outcome. Statistical analysis was done to study the correlation between microsurgical varicocelectomy outcome and testicular vein diameter at the inferior pole of the testis, and the degree of reflux measured by color Doppler ultrasound. RESULTS: Improvement index in sperm concentration, motility and morphology more than 0.5 was achieved in 58.8%, 27.3% and 17.6% of cases, respectively. We found that patients with a testicular vein diameter at the inferior pole of the testis of more than 2.5 mm have a significantly higher improvement index in sperm concentration, motility and morphology than patients with a testicular vein diameter less than 2.5 mm (p = 0.006, 0.016 and 0.041, respectively). We also found that patients with clear reflux detected by color Doppler ultrasound at the inferior pole of the testis have a significantly higher improvement index in sperm concentration, motility and morphology than patients with reflux detected only in the supratesticular venous channels (p = 0.013, 0.015 and 0.045, respectively). CONCLUSIONS: Color Doppler ultrasound is a useful tool for accurate diagnosis and grading of varicocele, and for predicting the outcome of varicocelectomy. We recommend varicocelectomy in cases of testicular vein diameter greater than 2.5 mm and in cases of reflux detected at the veins at the lower pole of the testis.     

高频彩色多普勒血流显像诊断乳腺恶性肿瘤

目的探讨高频彩色多普勒血流显像（CDFI）在乳腺恶性肿瘤诊断的临床应用。方法回顾60例在我院手术治疗的乳腺恶性肿瘤的CDFI高频超声声像图特征,并与手术、术后病理结果对照。结果乳腺恶性肿瘤在形态、边缘、包膜、内部回声、后方回声、纵横比具有特异性,乳腺恶性肿瘤内及周边血流信号丰富,肿瘤内部出现粗大彩色血流信号。结论高频彩色多普勒超声是一种对乳腺恶性肿瘤的诊断具有重要的临床应用价值的无创伤性检查方法。     

彩色多普勒超声在无精子症诊断中应用价值的评估

目的 评价超声在梗阻性无精子症诊断中的作用.方法 158例梗阻性无精子症患者,经过体格体检查、精液分析及血液激素水平测定后,均进行了阴囊超声及经直肠彩色多普勒超声检查.结果 在158例梗阻性无精子症患者的超声检查中,25例无阳性结果,133例超声检查结果异常,阳性率为84.2%.其病因是多方面的,包括远端梗阻和近端梗阻,共分为4种分类：（1）先天性发育异常,如：精囊缺失或精囊发育不良以及输精管单侧及双侧缺失（55例）;（2）射精管梗阻（EDO）（34例）;（3）附睾病变（25例）;（4）炎症性病变（19例）.结论 阴囊超声及经直肠超声检查是临床诊断梗阻性无精子症的重要手段.     

高频超声和彩色多普勒血流显像诊断腹股沟斜疝

目的探讨高频超声和彩色多普勒血流显像（CDFI）在腹股沟斜疝诊断中的价值。方法对79例高频彩超检查诊断腹股沟斜疝且经手术病理证实的患者进行回顾性分析。结果腹股沟斜疝表现为腹股沟区腹壁层内见疝囊,其近端通过疝囊颈（内环口）与腹腔相通,远端为边界清晰的盲端。高频彩超显示疝内容物为肠管时可见肠管管壁特点、气体回声、肠腔内容物,肠壁有多条彩色血流;内容物为大网膜时为簇状杂乱回声团或筛网状回声团,伴斑点状彩色血流。嵌顿疝及绞窄疝内的彩色血流有不同程度改变。腹壁下动脉在疝囊的后方、疝囊颈的内侧。精索紧贴疝囊的后壁。结论高频超声和CDFI能显示腹股沟斜疝内容物性质,指导选择手术时机和方法;CDFI对鉴别诊断、判断内容物损害程度及预后评估有重要价值。