Андрология и генитальная хирургия. 2014; 15: 58-62
Ультразвуковая соноэластография мошонки в диагностике фертильности мужчины
https://doi.org/10.17650/2070-9781-2014-2-58-62Аннотация
Цель: определение возможности использования соноэластографии мошонки в оценке репродуктивной функции мужчин.
Материалы и методы. Исследование проведено у мужчин 20–44 лет. Первую группу составили 25 больных с секреторным бесплодием. Во 2-ю группу включены 25 пациентов с бесплодием при варикоцеле. Третья группа (контрольная) включала 12 мужчин в возрасте 22–31 года с реализованной репродуктивной функцией (1 и более детей). Исследование проводили на ультразвуковом сканере экспертного класса Acuson S2000 производства компании «Сименс», использовался сверхвысокочастотный датчик 18L6 HD. Половые гормоны исследовались на иммунохемилюминесцентном анализаторе Ассess 2 производства Beckman Coulter (США). Получение и исследование эякулята проводили по Рекомендациям ВОЗ (5-е издание).
Результаты. Скорость сдвига поперечной волны Vs у мужчин с секреторным бесплодием и при варикоцеле составляла 1,5–1,6 м/с и была увеличена на 35–45 % по сравнению с аналогичным параметром у репродуктивно здоровых мужчин. Более чем в половине случаев подобное увеличение скоростных показателей и уменьшение площади картирования так называемых «мягких» участков придатка яичка сопровождалось снижением концентрации и доли активноподвижных сперматозоидов. Применение подобного метода инструментальной диагностики позволит на этапе предварительного ультразвукового скрининга заподозрить нарушение репродуктивного потенциала у мужчины.
Список литературы
1. Male Infertility Best Practice Policy Committee of the American Urological Association; Practice Committee of the American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril 2004;82(Suppl 1):S142–5.
2. Practice Committee of American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril 2008;90(Suppl 5):S247–9.
3. Dohle G.R., Colpi G.M., Hargreave T.B. et al.; EAU Working Group on Male Infertility. EAU guidelines on male infertility. Eur Urol 2005;48(5):703–11.
4. Jain T., Gupta R.S. Trends in the use of intracytoplasmic sperminjection in the United States. N Engl J Med 2007;357(3): 251–7.
5. Clarke B.G. Incidence of varicocele in normal men and among men of different ages. JAMA 1966;198(10):1121–2.
6. Yoneda M., Suzuki J., Kato S. et al. Nonalcoholic fatty liver disease: US-based acoustic radiation force impulse elastography. Radiology 2010;256(2):640–7.
7. Nightingale K., Soo M.S., Nightingale R., Trahey G. Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility. Ultrasound Med Biol 2002;28(2): 227–35.
8. Melodelima D., Bamber J.C., Duck F.A., Shipley J.A. Transient elastography using impulsive ultrasound radiation force: a preliminary comparison with surface palpation elastography. Ultrasound Med Biol 2007;33(6):959–69.
9. Nightingale K., McAleavey S., Trahey G. Shear-wave generation using acoustic radiation force: in vivo and ex vivo results. Ultrasound Med Biol 2003;29(12): 1715–23.
10. Garra B.S. Imaging and estimation of tissue elasticity by ultrasound. Ultrasound Q 2007;23(4):255–68.
11. Li M., Du J., Wang Z.Q., Li F.H. The value of sonoelastography scores and the strain ratio in differential diagnosis of azoospermia. J Urol 2012;188(5):1861–6.
Andrology and Genital Surgery. 2014; 15: 58-62
Ultrasonic sonoelastography of scrotum in the diagnosis of male fertility
https://doi.org/10.17650/2070-9781-2014-2-58-62Abstract
Objective: to determine the possibility of using detect the scrotum in assessing reproductive function of men.
Materials and methods. The study was conducted in men aged 20–44 years. The first group of men was 25 patients with secretory infertility. The second group included 25 male infertility varicocele. The control group presents 12 men in the age range 22–31 year with the implementation of the reproductive function of 1 or more children. The study was performed by ultrasonic scanner expert class Acuson S2000 manufacture of the company Siemens, was used microwave sensor 18L6 HD. Sex hormones were studied on immunochemiluminescence analyzer Access 2 production Beckman Coulter (USA). Obtaining and study of ejaculate was carried out according to Recommendations of the WHO (5th edition).
Results. The application of research shear transverse wave Vs men with secretory infertility and varicocele is accompanied by the increase of its value to 1.5–1.6 m/s and is characterized by 35–45 % from similar parameters of reproductive healthy men. In half of the cases studies such an increase in performance and decrease in the area of mapping the so-called “soft” areas of the epididymis is accompanied by a decrease in the concentration and actively motile sperm. The use of such method of instrumental diagnostics will allow at the stage of preliminary ultrasound screening to suspect a violation of the reproductive capacity of men.
References
1. Male Infertility Best Practice Policy Committee of the American Urological Association; Practice Committee of the American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril 2004;82(Suppl 1):S142–5.
2. Practice Committee of American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril 2008;90(Suppl 5):S247–9.
3. Dohle G.R., Colpi G.M., Hargreave T.B. et al.; EAU Working Group on Male Infertility. EAU guidelines on male infertility. Eur Urol 2005;48(5):703–11.
4. Jain T., Gupta R.S. Trends in the use of intracytoplasmic sperminjection in the United States. N Engl J Med 2007;357(3): 251–7.
5. Clarke B.G. Incidence of varicocele in normal men and among men of different ages. JAMA 1966;198(10):1121–2.
6. Yoneda M., Suzuki J., Kato S. et al. Nonalcoholic fatty liver disease: US-based acoustic radiation force impulse elastography. Radiology 2010;256(2):640–7.
7. Nightingale K., Soo M.S., Nightingale R., Trahey G. Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility. Ultrasound Med Biol 2002;28(2): 227–35.
8. Melodelima D., Bamber J.C., Duck F.A., Shipley J.A. Transient elastography using impulsive ultrasound radiation force: a preliminary comparison with surface palpation elastography. Ultrasound Med Biol 2007;33(6):959–69.
9. Nightingale K., McAleavey S., Trahey G. Shear-wave generation using acoustic radiation force: in vivo and ex vivo results. Ultrasound Med Biol 2003;29(12): 1715–23.
10. Garra B.S. Imaging and estimation of tissue elasticity by ultrasound. Ultrasound Q 2007;23(4):255–68.
11. Li M., Du J., Wang Z.Q., Li F.H. The value of sonoelastography scores and the strain ratio in differential diagnosis of azoospermia. J Urol 2012;188(5):1861–6.
