放射性核素阴囊闪烁显像术诊断精索静脉曲张的效果观察

目的　探讨放射性核素阴囊闪烁显像术对诊断精索静脉曲张的价值。方法　本文收集 30例临床检查和 (或 )精液化验定型为精索静脉曲张的病人 ,分别行阴囊闪烁显像术检查计算机定量分析描计时间放射性曲线 ,计算两侧阴囊区每像素平均计数值、阴囊血池指数值 ,并观测阴囊部位是否有血液返流 ,对精索静脉曲张进行分型、定度 ,并与临床检查和彩色多普勒血流显像结果对比。结果　三种检查方法对临床型精索静脉曲张的分度差别无显著意义 ;阴囊闪烁显像术与彩色多普勒显像对亚临床精索静脉曲张的分度差别无显著意义。结论　该方法是诊断临床型精索静脉曲张、亚临床精索静脉曲张的简单、安全、有效的无创诊断方法。     

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。     

阴囊核素显像结合生殖激素检测诊断精索静脉曲张的临床研究

精索静脉曲张（VC）是男性不育的常见原因之一,占男性不育患者的15％～20％,早期诊断并给予相应治疗可明显改善精液质量。本研究拟将阴囊血池显像与外周血生殖激素测定相结合对VC的诊断及意义进行探讨。     

~(99)Tc~m-MIBISPECT-MIBISPECT双时相显像、B超及CT在原发性甲状旁腺功能亢进症中的诊断价值

目的探讨~(99)Tc~m-甲氧基异丁基异腈单光子发射计算机断层显像(~(99)Tc~m-MIBI SPECT)双时相显像、B超及CT检查诊断原发性甲状旁腺功能亢进症(PHPT)的意义及与血清钙(CA)水平的关系。方法回顾性分析73例血清甲状旁腺激素(PTH)均大于130 pg/m L甲状旁腺功能异常患者的临床资料,73例患者均行~(99)Tc~m-MIBI SPECT双时相显像检查,63例行颈部B超检查,16例行CT检查;根据血清钙(CA)水平将患者分为CA2.7 mmol/L组和CA2.7mmol/L组,并以术后病理学检查及随访结果为标准,比较不同血清CA水平下~(99)Tc~mMIBI SPECT双时相显像、B超及CT检查诊断PHPT的灵敏度、特异度、阳性预测值及阴性预测值。结果 ~(99)Tc~mMIBI SPECT双时相显像、B超和CT检查诊断PHPT的灵敏度分别为87.6%、81.8%及35.7%,特异度分别为87.5%、75.5%及50.0%,阳性预测值分别为98.2%、93.7%及83.3%,阴性预测值分别46.7%、33.3%和10.0%。~(99)Tc~mMIBI SPECT双时相显像和B超检查诊断PHPT的灵敏度、特异度、阳性预测值及阴性预测值均明显高于CT检查(P0.05);~(99)Tc~m-MIBI SPECT双时相显像诊断PHPT的灵敏度、特异度、阳性预测值及阴性预测值高于B超检查,但差异无统计学意义(P0.05)。在CA2.7 mmol/L组,~(99)Tc~m-MIBI SPECT双时相显像、B超及CT检查诊断PHPT的灵敏度分别为91.1%、84.7%和37.9%,特异度分别为80.2%、72.9%及49.7%,阳性预测值分别为96.8%、96.0%和79.4%,阴性预测值分别为50.0%、37.5%及10.0%;在CA2.7mmol/L组,~(99)Tc~m-MIBI SPECT双时相显像、B超及CT检查诊断PHPT的灵敏度分别为87.9%、83.9%及42.8%,特异度分别为83.3%、79.2%及50.0%,阳性预测值分别为96.9%、94.1%及75.0%,阴性预测值分别为50.0%、40.5%及20.0%,2组间3种检查方法的诊断准确性的差异均无统计学意义(P0.05)。结论 ~(99)Tc~m-MIBI SPECT双时相显像和B超在PTH大于130 pg/m L的PHPT患者中(尤其甲状旁腺腺瘤)其诊断准确性明显高于CT,且与血清CA浓度无关。     

普通彩色多普勒血流显像技术在小儿肝移植术后早期肝动脉栓塞中的诊断价值

目的评价普通彩色多普勒血流显像(CDFI)技术在小儿肝移植术后早期肝动脉栓塞(HAT)中的诊断价值。方法回顾性分析2005年4月至2014年5月在武警总医院施行的55例小儿肝移植病例的临床资料。对所有病例在术后早期应用CDFI技术进行常规血流监测。经CDFI多切面检查于肝内未见肝动脉血流信号拟诊HAT,对怀疑HAT者进行计算机体层摄影术血管造影(CTA)检查或手术探查。应用Chiss统计软件,计算普通CDFI技术诊断HAT的灵敏度和特异度。结果 55例小儿肝移植受者中,CDFI检查共拟诊3例HAT,其中2例为肝动脉主干栓塞,1例为肝右动脉栓塞,均经CTA检查和手术探查证实诊断。本组病例HAT发生率为5%(3/55)。应用普通CDFI技术诊断小儿肝移植术后HAT的灵敏度为1.0、特异度为1.0、假阳性率为0。结论普通CDFI技术为小儿肝移植术后血流动力学检测首选的、最主要的检查手段,经验丰富的移植超声医师实施检查可提高诊断HAT的准确性。     

彩色多普勒超声诊断阴囊疾病118例临床分析

目的 探讨彩色多普勒超卢(CDFI)对阴囊疾病的诊断价值.方法 回顾性分析1996年-2006年采用二维超声和CDFI观察的118例患者睾丸、阴囊内结构和血供情况的超声资料,并经手术和病理检查及临床随访证实.结果 118例患者中,12例急性睾丸炎,18例慢性附睾炎,5例附睾结核,4例附睾炎性结节,3例附睾尾部脓肿,5例精液囊肿,28例睾丸肿瘤,7例阴囊及睾丸血肿,25例精索静脉曲张,10例鞘膜积液,1例睾丸肉芽肿.结论 CDFI作为一种经济实用、直观,无创并可重复性的检查方法,是目前诊断阴囊疾病首选方法.     

彩色多普勒超声在阴囊肿块鉴别诊断中的价值

目的:通过观察阴囊肿块的超声图像特征,探讨彩色多普勒超声(CDFI)在阴囊肿块鉴别诊断中的价值。方法:对手术并经病理证实的21例阴囊肿块的临床及术前肿块的超声图像进行回顾分析。结果:在21例阴囊肿块中,恶性肿瘤8例,占38.1%(8/21),且均来源于睾丸,;良性肿块13例,占61.9%(13/21),其中来源于睾丸外11例,占84.6%(11/13),来源于睾丸的2例,占15.4%(2/13)。结论:CDFI对阴囊肿块的鉴别诊断有较大价值。     

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.     

金冷法对精索静脉曲张症状缓解的探讨

目的:探讨金冷法对精索静脉曲张(VC)所致阴囊温度升高和临床症状的疗效。方法:51例VC患者使用金冷内裤(金冷法)治疗,早晚各1次,每次30min,疗程90d。观察治疗前后阴囊温度和临床症状的变化。结果:连续使用金冷法治疗90d后,VC组的左阴囊温度由(32.16±0.79)℃降为(31.53±0.77)℃(P<0.01),右阴囊温度由(31.91±0.73)℃降为(31.81±0.63)℃(P>0.05);治疗前后VC组患者阴囊潮湿、发热,阴囊坠胀,腰酸、腰胀,头痛、头晕、乏力、焦虑症状评分变化比较,具有显著性差异(P<0.05);治疗前后睾丸疼痛症状评分变化比较,具有显著性差异(P<0.01);IIEF-5评分由就诊时的(15.89±6.13)分提高到(20.04±3.87)分,具有显著性差异(P<0.01)。结论:金冷法可作为一种轻、中度精索静脉曲张的治疗手段。     

精索扭转28例临床探讨

目的：探讨精索扭转的临床诊疗方法。方法：回顾性总结28例精索扭转患者的临床资料，结合文献进行分析、讨论。结果：25例经手术探查证实与术前彩色多普勒血流动态显像（cDFI）或阴囊核素显像诊断相符。3例行手法复位，12例行手术复位、固定，13例行患侧睾丸切除，手术病例均行对侧睾丸固定。结论：CDFI或阴囊核素显像有助于精索扭转的早期诊断，早期明确诊断或有高度怀疑时，应立即进行手术探查。     

Evaluation of the role of varicocelectomy including external spermatic vein ligation in patients with scrotal pain

OBJECTIVES: The aim of the present study was to assess and compare pre- and postoperative scrotal pain in patients with varicocele who underwent varicocelectomy with different approaches. METHODS: The study included 144 consecutive patients with left-sided varicocele who had left scrotal pain for more than 3 months. All patients underwent varicocele ligation using either a subinguinal or inguinal approach with or without external spermatic vein ligation. We asked the patients to complete an 'Assessment Questionnaire for Scrotal Pain' both before and after the surgery. RESULTS: The surgery was successful in 101 (83.4%) of the 121 patients available for follow up. Seventy-four (61.1%) patients reported the complete resolution of pain while 27 patients (22.3%) reported partial resolution. Symptoms worsened in a single case and pain persisted postoperatively in 19 cases (15.7%). There were no statistically significant differences in the characteristics of the pain and grade of varicocele between postoperative groups. A significant difference was observed in postoperative success between patients who had external spermatic vein ligation and those who did not, regardless of the surgical approach (inguinal or subinguinal). All patients who reported complete or partial resolution of pain stated that they would recommend surgery to relatives with the same problem. CONCLUSIONS: Varicocelectomy using either inguinal or subinguinal approaches is an effective and reasonable treatment option in this patient group and should include external spermatic vein ligation for a satisfactory outcome.     

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。     

Comparison between thermography and venous scintigraphy of the scrotum in the diagnosis of varicocele

Fifty-one consecutive infertile men were examined for the presence of (sub)clinical varicocele with both scrotal thermography and venous radionuclide scintigraphy. Venous scintigraphy with 99^mTC yielded false negative results in about half of the patients suspected of varicocele because of clinical findings and/or abnormal scrotal thermography. Venous scintigraphy cannot serve as an alternative for scrotal thermography for the detection of spermatic venous reflux in varicocele.     

Sonographic quantitative evaluation of scrotal veins in healthy subjects: normative values and implications for the diagnosis of varicocele

OBJECTIVES: To define the normative values of scrotal vein diameters, investigate the eventual presence and characteristics of scrotal reflux in healthy subjects, and describe its implication for the diagnosis of scrotal varicocele. METHODS: Color-Doppler ultrasonography was performed on a population of 145 healthy, symptomless subjects, with clinical examinations and semen analyses within normal limits. RESULTS: The upper limit of the scrotal veins diameter (3.7-3.8mm) exceeds values presently employed for a diagnosis of varicocele. Furthermore, a high percentage of healthy subjects (53%) were found to have reflux in the scrotal veins, currently considered one of the criteria for diagnosing varicocele, especially in its subclinical form. CONCLUSIONS: To reduce the risk of misinterpretations between the various specialists involved in Color-Doppler ultrasonography and urologists, quantitative data of the scrotal veins (i.e., maximum diameter and the presence, velocity, and duration of reflux) should be described in reports of sonographic examinations performed for scrotal varicocele.     

Antegrade scrotal sclerotherapy and varicocele

Antegrade scrotal sclerotherapy is a simple and easy technique for the treatment of varicocele. The success rate varies between 87% and 95%. The initial reflux grade and the number of collateral vessels of the spermatic vein are the most important factors to predict the outcome of the technique. The postoperative complication rate is about 7% and the common ones are scrotal hematoma and epididymo-orchitis of slight severity. Testicular athrophy is a rare event (0.6%). This technique offers a considerable cost reduction compared to other therapeutic options currently available for varicocele.     

Scrotal infrared digital thermography in assessment of varicocele--pilot study to assess diagnostic criteria

The aim of this study was to assess scrotal thermography in diagnostics of varicocele and suggest potential diagnostic criteria. Twelve patients with clinically diagnosed varicocele were examined with scrotal infrared digital thermography, physical examination and ultrasound/doppler. The main outcome measure was evaluation of thermography diagnostic criteria for varicocele. Mean temperature at left pampiniform plexus was ≥ 34 °C in 83%, and at right pampiniform plexus in all cases was ≤ 34 °C. In 92% of patients, temperature at the left testicle was ≥ 32 °C, whereas at the right testicle it was >32 °C in 50% patients. Temperatures between left and right pampiniform plexus and between left and right testicle were significantly different with P < 0.0001 and P < 0.006 respectively. In all patients, temperature difference between pampiniform plexuses was ≥ 0.6 °C. In 92% of patients, temperature at left pampiniform plexus was equal or higher to thigh temperature with the mean temperature difference of 1.1 ± 1.1 °C. Temperature at right pampiniform plexus was colder than the thigh in 92% of patients. This study suggests diagnostic criteria of five thermographic signs to easily diagnose varicocele. Scrotal thermography presents feasible, short and low cost diagnostic method for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate sensitivity and specificity of this method.     

Retroperitoneal high ligation versus subinguinal varicocelectomy: Effectiveness of two different varicocelectomy techniques on the treatment of painful varicocele

In the present study, we compared the retroperitoneal high ligation with subinguinal varicocelectomy on the treatment of painful varicocele. A total of 90 patients who underwent retroperitoneal high ligation (n = 45) and subinguinal varicocelectomy (n = 45) for painful varicocele were included in this prospective study. Varicocele in all patients was diagnosed with by physical examination and coloured Doppler ultrasonography. All the patients underwent a conservative treatment for pain for 4 weeks. Patient ages, varicocele grades, preoperative pain scores, postoperative pain scores at 6 months, duration of surgeries, complications and recurrences were recorded. Complete success rate for chronic scrotal pain was found to be 80% in retroperitoneal varicocelectomy group and 71% in subinguinal varicocelectomy group. Partial success rate was 11% for retroperitoneal varicocelectomy group and 18% for subinguinal ligation group. There was no significant difference between two groups in terms of pain and complications. However, the operation time was significantly lower in the Palomo group. Although microsurgical subinguinal varicocelectomy is the current approach for the treatment of varicocele, retroperitoneal high ligation can achieve the same pain resolution with shorter operative duration compared to loupe‐assisted subinguinal varicocelectomy.