Preliminary investigation of the diagnostic value of shear wave elastography in evaluating the testicular spermatogenic function in patients with azoospermia
Preliminary investigation of the diagnostic value of shear wave elastography in evaluating the testicular spermatogenic function in patients with azoospermia
复制标题
剪切波弹性成像评估无精症患者睾丸生精功能的诊断价值初探
作者：
Hu Jia-Ying;Huang Wan-Ling;Gao Yong;Yang Zheng;Ding Li;Xie Yun;Xie Xiao-Yan;Hu Hang-Tong;Wang Zhu
为了评估剪切波弹性成像（SWE）对无精子症男性组织学生精功能的诊断价值，回顾性招募了91例接受标准化灰阶超声和SWE检查并随后进行睾丸活检的无精子症患者。生精功能通过活检分为正常睾丸生精（n= 61）、精子生成不足（n= 18）、生精停滞（n= 6）和仅支持细胞综合征（n= 6）。在这4组之间观察到睾丸大小和SWE值的显著差异（p<0.01）。平均SWE值具有良好的区分能力（AUC = 0.79），临界值为1.55 KPa，灵敏度为0.58，特异性为0.85，阳性预测值（PPV）为0.36，阴性预测值（NPV）为0.93。睾丸体积的AUC为0.75。当临界值为8.41 ml时，睾丸体积的灵敏度为0.58，特异性为0.92，PPV为0.54，NPV为0.93。平均SWE值和睾丸体积可有效区分正常生精和生精不足患者与仅支持细胞综合征和生精停滞患者。
To assess the diagnostic value of shear wave elastography (SWE) for evaluating the histological spermatogenic function of azoospermic males, 91 patients with azoospermia who underwent standardised greyscale ultrasound and SWE examinations followed by testicular biopsy were retrospectively recruited. Spermatogenic function was classified by biopsy as normal testicular spermatogenesis (n= 61), hypospermatogenesis (n= 18), spermatogenesis arrest (n= 6) and Sertoli cell‐only syndrome (n= 6). Significant differences in testicular size and SWE values were observed between these 4 groups (p< .01). The mean SWE value had good discrimination power (AUC = 0.79) with a cut‐off value of 1.55 KPa, a sensitivity of 0.58, specificity of 0.85, positive predictive value (PPV) of 0.36 and negative predictive value (NPV) of 0.93. Testicular volume had an AUC of 0.75. With a cut‐off value of 8.41 ml, the testicular volume had a sensitivity of 0.58, specificity of 0.92, PPV of 0.54 and NPV of 0.93. The mean SWE value and testicular volume efficiently discriminated patients with normal spermatogenesis and hypospermatogenesis from patients with Sertoli cell‐only syndrome and spermatogenesis arrest.