长期输精管结扎术后附睾的超声表现

目的:探讨长期输精管结扎术后附睾的超声表现。方法:选择输精管结扎术后10～31年且有临床症状的患者64例(结扎组)。同时选择同期被临床诊断为附睾疾病而无结扎史的患者60例作为对照组。用高频超声观察附睾头、体、尾部的形态,厚度及内部回声;用彩色多普勒血流图或能量图观察附睾的血流状况。结果:结扎组附睾体部增厚、尾部增厚、头体尾均增厚及附睾管扩张的发生率分别为64.1%、78.1%、42.2%、54.7%,均显著高于对照组的15.0%、51.7%、8.3%、8.3%(P<0.01),而结扎组附睾的高血供发生率15.6%显著低于对照组的61.7%(P<0.01)。结论:长期输精管结扎术后附睾的主要超声表现是附睾增厚、附睾管扩张,但附睾血流多为无血供或低血供状况。

Ultrasonographic Changes in the Epididymis after Long-term Vasectomy

OBJECTIVE: To evaluate the ultrasonographic changes in the epididymis after long-term vasectomy. METHODS: Sixty-four patients with a history of vasectomy for more than 10 years (vasectomy group) and another 60 without vasectomy (control group) were included in the study. The patients were referred to scrotal ultrasonography for epididymal indications. The shape, thickness and internal echoes of the head, body and tail of the epididymis were observed with high frequency ultrasonography (HFU), and the blood flow changes were observed with color Doppler flow imaging (CDFI) or color Doppler power imaging (CDPI). RESULTS: Significantly higher rates were found in the vasectomy group than in the control: thickened body (64.1% vs 15.0%) and tail (78.1% vs 51.7%) of the epididymis, thickened head, body and tail (42.2% vs 8.3%) of the epididymis, and epididymal tubular ectasia (54.7% vs 8.3%). However, increased blood flow in the epididymis was seen at a significantly lower rate in the vasectomy group than in the control (15.6% vs 61.7%). CONCLUSION: The ultrasonographic changes in the epididymis after long-term vasectomy were mainly epididymis thickening and epididymal tubular ectasia, mostly with no or diminished blood flow in the epididymis.