彩色多普勒超声对亚临床型精索静脉曲张的诊断价值

目的探讨亚临床型精索静脉曲张(SVC)的彩色多普勒超声表现。方法对手术证实的80例患者共103条SVC的彩色多普勒超声检查资料及手术前后的精液检测参数进行分析研究。结果单纯左侧SVC57例(71.25%),双侧SVC23例(28.75%),精索静脉内径为(1.90±0.35)mm,反流时间(1.48±0.26)s,反流速度(4.95±1.97)cm/s。57例左侧SVC的睾丸体积左右侧分别为(9.12±3.46)ml和(12.19±4.69)ml,两侧相比差异有统计学意义(P<0.05);23例双侧SVC睾丸体积左右侧分别为(8.79±3.14)ml和(9.10±3.87)ml,差异无统计学意义(P>0.05)。术后3、6及12个月的精子密度、精子存活率、正常形态精子百分率与术前比较差异均呈非常显著性(P<0.01)。结论彩色多普勒超声能够准确诊断SVC,并为评价精索静脉高位结扎术后疗效提供客观指标。     

彩色多普勒超声对精索静脉曲张术后生育力指数变化的预测价值

目的 探讨精索静脉曲张的彩色多普勒超声分级对术后患者生育力指数变化的预测.方法 选择151例经彩色多普勒超声诊断并分级的精索静脉曲张患者,分析蔓状静脉的最大内径与反流程度之间的关系,并以蔓状静脉反流程度和最大内径进行分组,对比分析各组精索静脉高位结扎术前后生育力指数的变化.结果 蔓状静脉最大内径>1.5 mm时即可检出病理性反流,蔓状静脉内径大小与反流程度呈正相关(r=0.89).Ⅰ级反流组的手术前后生育力指数差异无统计学意义(P>0.05),Ⅱ级、Ⅲ级反流组的手术前后生育力指数差异具有显著统计学意义(P<0.01).蔓状静脉内径≤2.0 mm的患者术后生育力指数差异无统计学意义(P>0.05),内径2.1～3.0 mm的术后生育力指数差异具有统计学意义(0.013.0 mm组的术后生育力指数差异具有湿著统计学意义(P<0.01).结论 精索静脉曲张的彩色多普勒超声分级能够预测患者术后精液质量的变化,蔓状静脉内径≤2.0 mm的或仪在Valsalva试验时蔓状静脉出现病理性反流的精索静脉曲张患者不必要进行手术治疗.     

二维灰阶血流成像技术(B-flow)在超声诊断亚临床型精索静脉曲张中的价值研究

目的:探讨二维灰阶血流成像技术(B-flow)在超声诊断亚临床型精索静脉曲张(Subclinical varicocele,SVC)中的应用价值.方法:对68例经手术证实为SVC患者超声检查时应用CDFI、脉冲多普勒(PW)、B-flow技术测量精索静脉的内径、血流和反流时间等数据进行分组对比分析.结果:超声诊断依据B-flow结合CDFI、PW技术的研究组数据比仅依据CDFI、PW技术对照组数据SVC患者的检出率、准确率高.结论:超声检查精索静脉时B-flow技术的应用有助于提高SVC患者的检出率、准确率.     

超声分级结合血清生殖激素评估精索静脉曲张患者生育力

目的 探讨超声分级结合血清生殖激素评估精索静脉曲张（VC）患者生育力的价值。方法 根据彩色多普勒超声所见，将90例VC并接受精索静脉高位结扎术患者分为A（Ⅰ级）、B（Ⅱ级）、C（Ⅲ级）3组，各30例；以30名正常生育男性纳入对照组（D组）。分别于术前、术后测定并分析各VC组血清生殖激素及精液质量的变化特点及相关性。结果 ①与D组比较，A、B、C组术前精子浓度、存活率及前向运动百分率（PR）均降低；血清卵泡刺激素（FSH）、黄体生成素（LH）升高，睾酮（T）、抑制素B（InhB）下降（P均<0.05）；A、B组与C组血清LH、FSH及T水平差异均有统计学意义（P均<0.05）；VC患者血清InhB水平与精子浓度（r=0.51，P<0.01）和PR（r=0.38，P<0.01）呈正相关；②除A组外，B、C组术后精液质量不同程度改善，血清InhB、FSH、LH水平较术前均有不同程度提高（P均<0.05），而T下降（P<0.05）；③相同超声级别VC组内，术前血清InhB水平较高者术后精液质量改善更显著。结论 VC患者术后生精功能改善程度与曲张程度密切相关，且受血清生殖激素水平等因素影响。超声分级结合血清生殖激素等可有效评估VC患者生育力。     

彩色多普勒诊断精索静脉曲张的价值

目的:探讨彩色多普勒超声诊断精索静脉曲张的价值。方法:彩色多普勒超声测量不同曲张程度的精索静脉管径及流速,进行统计学处理。结果:精索静脉曲张程度的彩色多普勒反映的指标差异均有统计学意义(P<0.001)。结论:彩色多普勒超声诊断精索静脉曲张以血管管径与彩色血流情况相结合为诊断标准。     

彩色多普勒超声对精索静脉曲张的诊断价值

精索静脉曲张是导致男性不育症的重要因素 ,应用高频彩超对精索静脉曲张的诊断是近十年发展起来的一种无创性影像诊断方法 ,由于其诊断准确率高 ,现已逐步替代了传统的选择性肾静脉造影及逆行精索内静脉造影 ,成为当前精索静脉曲张最有价值的诊断方法之一[1,2 ] 。1　精索静脉及其周围结构的解剖精索静脉收集睾丸和附睾的血流 ,环绕输精管形成蔓状静脉丛。向上至腹股沟管外环处逐渐汇合成 2～ 3条精索内静脉 ,沿腹股沟管走行 ,经腹环进入腹膜后间隙 ,右侧以锐角直接汇入下腔静脉 ,左侧以直角汇入左肾静脉 ,入口处有瓣膜防止逆流。如果瓣膜先…     

超声检查对不育男性精索静脉曲张的诊断价值

目的：探讨超声检查在不育男性精索静脉曲张(VC)诊断中的临床意义。方法：回顾性分析经手术证实的32例VC患者，比较超声检查与临床触诊两种方法的确诊率。结果：130例不育男性中超声检查共发现VC患者32例，均经手术证实。通过触诊确诊19例．其敏感性、可靠性、特异性分别是多普勒超声的59．4％、90．5％和98．0％。结论：彩色多普勒超声明显优于临床触诊，是诊断VC的重要方法。     

超声造影定量分析在精索静脉曲张诊断中的应用价值

摘 要 目的 探讨超声造影（CEUS）定量分析在精索静脉曲张（VC）诊断中的应用价值。方法 选取我院左侧VC患者27例为研究组,同期健康男性志愿者27例为对照组,所有受检者均行CEUS检查双侧精索静脉,获得CEUS定量参数：精索动静脉渡越时间（TT）、精索静脉到达时间（ATV）、静脉达峰所需时间（TTPV）、静脉达峰时间（PTV）、静脉峰值减半时间（WOT50%）、静脉半衰期（HTV）,比较两组上述参数的差异。结果 研究组左侧与右侧精索静脉TT、ATV、TTPV、PTV、WOT50%、HTV比较差异均有统计学意义（均P＜0.05）;对照组左侧与右侧精索静脉各CEUS定量参数比较差异均无统计学意义。研究组与对照组左侧精索静脉TT、ATV、TTPV、PTV、WOT50%、HTV比较差异均有统计学意义（均P＜0.05）;右侧精索静脉各CEUS定量参数比较差异均无统计学意义。结论 CEUS定量参数能够反映精索静脉血流动力学情况,在VC诊断中有一定的应用价值。     

彩色多普勒超声在精索静脉曲张中的诊断价值

目的探讨彩色多普勒超声在精索静脉曲张(VC)中的诊断价值。方法对45例VC患者(观察组)及45例同期健康体检者(对照组)均采用MyLab20型彩色多普勒超声仪进行精索静脉检测,观察2组受检者在平静呼吸及Valsalva试验时精索内静脉内径(DV)、反流持续时间(TR)及最大反流速度(Vmax)的变化,评估彩色多普勒超声诊断的价值。结果观察组VCⅠ型14例,Ⅱ型23例,Ⅲ型8例。二维超声显示阴囊根部精索内呈蜂窝样结构;彩色多普勒显示蜂窝样结构内可见红蓝相间的静脉血流彩色信号,TR>1 s。Valsalva试验管腔呈内径增宽征象。观察组在平静呼吸及Valsalva试验时DV、TR及Vmax均明显高于对照组(均P<0.05)。结论彩色超声多普勒对VC有较大的诊断价值。     

彩色多普勒超声对精索静脉曲张不育患者的诊断价值

目的 研究彩色多普勒超声对精索静脉曲张不育症患者诊断价值。方法 应用彩色多普勒超声对56例精索静脉曲张不育患者精索静脉的管径和血液返流进行测定，并结合精液质量进行分析。结果 (1)病侧精索静脉直径增粗，可探及返流；(2)精索静脉的管径与生育力指数呈负相关，与血液返流的Doppler分级呈正相关。结论 (1)彩色多普勒超声可为临床提供精索静脉的形态及血流动力学改变的双重信息，可作为精索静脉曲张不育患者首选检查；(2)精索静脉的管径可能反映了精索静脉中血液返流的时间和严重程度，结合精液分析可估价精索静脉曲张患者生育力损害的程度。     

Association between varicocele and chronic obstructive pulmonary disease

PURPOSE: To evaluate the relationship between varicocele and chronic obstructive pulmonary disease (COPD) via color duplex sonography. MATERIALS AND METHODS: Forty-four male patients with COPD (age range, 50-89 years; mean +/- SD, 66 +/- 9) and 44 male healthy controls (age range, 47-75 years; mean +/- SD, 65 +/- 6) were evaluated with color duplex sonography for unilateral or bilateral varicocele. RESULTS: The incidence of right, left, and bilateral varicocele was 47.7%, 65.9%, and 38.6% respectively, in the COPD group, versus 22.7%, 52.3%, and 13.6% in the control group. The incidence of right and bilateral varicocele in the COPD group was significantly higher than in the control group (p < 0.05). The incidence of varicocele also increased with increase in COPD severity. CONCLUSIONS: The incidence of varicocele in COPD patients is high. Varicocele might be one of the most important causes of scrotal pain and infertility in COPD patients.     

Intratesticular varicocele

Varicocele is a common condition, occurring in approximately 15% of males. We present a case of intratesticular varicocele with concomitant extratesticular varicocele. A routine sonographic examination of the left testis revealed multiple hypoechoic, serpiginous, tubular intratesticular structures of various sizes with low-level internal echoes. Duplex Doppler and color flow examination confirmed a low-flow venous pattern with phasic variation that increased during Valsalva's maneuver. These findings were consistent with intratesticular varicocele. Varicocele was also present in the left pampiniform plexus. The main differential considerations in a patient with intratesticular varicocele include cyst, hematoma, epidermoid cyst, and tubular ectasia. © 1998 John Wiley & Sons, Inc. J Clin Ultrasound 26 : 49–51, 1998.     

Intratesticular arterial resistance and testicular volume in infertile men with subclinical varicocele

PURPOSE: The aim of this study was to evaluate whether intratesticular arterial resistance and testicular volume differed between infertile men with subclinical varicoceles and infertile men without varicoceles. MATERIALS AND METHODS: Fifty-eight infertile men were examined by gray-scale and color Doppler sonography for presence of varicocele, testicular volume, and arterial resistance. For men in the study group, mean testicular volume and resistance index (RI) in testes with varicoceles were compared with those in the contralateral testis by the paired t-test; statistical analyses between the study and control groups were performed by independent t-tests. RESULTS: Twenty-seven men had left-sided varicoceles (96% of which were subclinical), and 31 infertile men without varicoceles served as controls. Mean volumes of the right and left testes of study subjects were 14.8 ml and 14.6 ml, respectively, and in controls were 14.2 ml and 13.6 ml, respectively. Mean RI values for the right and left testes of study subjects were 0.61 and 0.58, respectively, and in controls were 0.61 and 0.58, respectively. There were no statistically significant differences in volume or RI, either between the right and left testes within patient groups or between the control and study groups' combined mean values. While the mean intertesticular volume differences for the study and control groups were 2.2 ml and 3.4 ml, respectively, the mean intertesticular RI differences were 0.04 and 0.07, respectively. These values also did not differ significantly between the 2 groups. CONCLUSIONS: Subclinical varicocele is not associated with ipsilateral testicular atrophy, and does not affect the intratesticular arterial RI.     

精索静脉曲张超声诊断及分度标准研究进展

精索静脉曲张由精索内蔓状静脉丛异常扩张导致,是不育症的常见病因之一。超声检查在精索静脉曲张的诊断中具有重要价值,同时还能对精索静脉曲张进行分度,为进一步临床治疗提供依据;但目前对于超声诊断精索静脉曲张的标准及分度标准仍存争议。本文针对相关研究进行综述,旨在探讨适用于中国人精索静脉曲张的超声诊断及分度标准。     

Incidence of the retroaortic left renal vein in patients with varicocele.

OBJECTIVE: The purpose of this study was to investigate the incidence of the retroaortic left renal vein (RLRV) in patients with varicocele. METHODS: The left renal vein was ultrasonographically investigated for the presence of the RLRV in 140 patients with varicocele and a control group of 137 age-matched patients. The main diagnostic criteria for varicocele were the presence of a varicose vein with a diameter of 3 mm or larger at rest and with a reflux lasting more than 2 seconds during the Valsalva maneuver. The RLRV was defined as a posterior course of the left renal vein to the aorta at the level of the origin of the superior mesenteric artery. RESULTS: The RLRV was observed in 13 (9.3%) of the 140 patients with varicocele and 3 (2.2%) of the control patients. The incidence of the RLRV was found to be significantly higher in patients with varicocele compared with the control patients (P = .018, Fisher exact test). In 13 patients with the RLRV, left varicocele and bilateral varicocele were detected in 10 and 3 cases, respectively. CONCLUSIONS: In this study, the incidence of the RLRV was found to be significantly higher in patients with varicocele compared with control patients. Thus, we suggest that the presence of the RLRV may be considered one of the etiologic factors in the development of varicocele.     

超声在男性不育症精索静脉曲张睾丸检测中的应用

目的应用超声研究单侧精索静脉曲张(VC)引起男性不育患者双侧睾丸体积及回声强度改变情况.方法应用高频超声测量35例正常人和130例左侧VC男性不育患者的双侧睾丸体积,并用直方图采样分析睾丸回声强度. VC按照临床触诊及超声检查分为亚临床型(SVC)及临床型Ⅰ～Ⅲ级(VCⅠ、VCⅡ及VCⅢ).结果单侧VC可引起双侧睾丸体积变小、回声减低,VC越严重则改变越明显.结论超声显像是评价VC不育患者睾丸体积及回声强度等客观指标的准确有效方法.     

Role of ultrasound in the assessment of male infertility

The use of ultrasonography has become an important component in the evaluation and treatment of male reproductive tract disorders. From the use of color flow Doppler ultrasonography for the assessment of varicoceles to transrectal ultrasonography combined with seminal vesiculography for the evaluation of ejaculatory duct obstruction, ultrasonography has practical clinical applications. In this article, the authors review the indications and use of ultrasonography in the assessment and treatment of the infertile male. The recent advances in diagnostic transrectal ultrasonography for ejaculatory duct obstruction, in particular, are emphasized. © 1996 John Wiley & Sons, Inc.