METHODS: Sixty healthy male rabbits were randomly assigned to one of three groups: complete testicular torsion, incomplete testicular torsion, or control. All rabbits underwent preoperative and postoperative scrotal ultrasonography, including shear wave elastography (SWE), at predetermined intervals. Changes in SWE values were analyzed and compared using repeatedmeasures analysis of variance. To assess the diagnostic performance of SWE in determining the degree of spermatogenic function impairment, the areas under the receiver operating characteristic curves (AUCs) were calculated.
RESULTS: SWE measurements in both central and peripheral zones of the testicular parenchyma affected by torsion demonstrated significant negative correlations with spermatogenesis, with coefficients of r=-0.759 (P<0.001) and r=-0.696 (P<0.001), respectively. The AUCs of SWE measurements in the central or peripheral zones of the torsed testicular parenchyma were 0.886 (sensitivity, 83.3%; specificity, 100%) and 0.824 (sensitivity, 83.3%; specificity, 73.3%) for distinguishing between hypospermatogenesis and spermatogenic arrest, respectively (P=0.451, DeLong test).
CONCLUSIONS: Variations in the stiffness of both central and peripheral regions of the testicular parenchyma correlate with the extent and duration of torsion, exhibiting a specific pattern. The \"stiff ring sign\" is the characteristic SWE finding associated with testicular torsion. SWE appears to aid in the non-invasive determination of the extent of spermatogenic damage in torsed testes.
方法:将60只健康雄性大白兔随机分为完全性睾丸扭转、不完全睾丸扭转,或控制。所有兔均行术前、术后阴囊超声检查,包括剪切波弹性成像(SWE),在预定的时间间隔。使用重复测量方差分析对SWE值的变化进行分析和比较。为了评估SWE在确定生精功能损害程度方面的诊断性能,计算受试者工作特征曲线下面积(AUC).
结果:在受扭转影响的睾丸实质的中央和外周区的SWE测量显示与精子发生显著负相关,系数为r=-0.759(P<0.001)和r=-0.696(P<0.001),分别。扭转睾丸实质的中央或外围区域的SWE测量的AUC为0.886(灵敏度,83.3%;特异性,100%)和0.824(灵敏度,83.3%;特异性,73.3%)用于区分精子发生不足和生精停滞,分别为(P=0.451,DeLong检验)。
结论:睾丸实质中央和外周区域的硬度变化与扭转的程度和持续时间相关,展示一个特定的模式。“僵硬环征”是与睾丸扭转相关的特征性SWE发现。SWE似乎有助于非侵入性地确定扭转睾丸中生精损伤的程度。