本研究旨在评估睾丸网厚度(RTT)和睾丸剪切波弹性成像(SWE)区分阻塞性无精子症(OA)和非阻塞性无精子症(NOA)的能力。我们在上海市总医院评估了145例无精子症不育男性的290例睾丸和47名健康志愿者的94例睾丸(上海,中国)2019年8月至2021年10月。睾丸体积(电视),SWE,比较OA和NOA患者与健康对照组之间的RTT和RTT。使用接收器工作特性曲线评估了三个变量的诊断性能。电视,SWE,OA中的RTT与NOA中的RTT差异显着(所有P≤0.001),但与健康对照组相似。在9-11cm3的电视上,OA和NOA的男性相似(P=0.838),有了敏感性,特异性,尤登指数,曲线下面积为50.0%,84.2%,0.34和0.662(95%置信区间[CI]:0.502-0.799),分别,对于3.1kPa的SWE截止值;和94.1%,79.2%,0.74和0.904(95%CI:0.811-0.996),分别,对于1.6毫米的RTT截止。结果表明,在TV重叠范围内,RTT在区分OA和NOA方面的表现明显优于SWE。总之,超声RTT评估被证明是区分OA和NOA的一种有前途的诊断方法,特别是在电视重叠范围内。
This study aimed to evaluate the ability of rete testis thickness (RTT) and testicular shear wave elastography (SWE) to differentiate obstructive azoospermia (OA) from nonobstructive azoospermia (NOA). We assessed 290 testes of 145 infertile males with azoospermia and 94 testes of 47 healthy volunteers at Shanghai General Hospital (Shanghai, China) between August 2019 and October 2021. The testicular volume (TV), SWE, and RTT were compared among patients with OA and NOA and healthy controls. The diagnostic performances of the three variables were evaluated using the receiver operating characteristic curve. The TV, SWE, and RTT in OA differed significantly from those in NOA (all P ≤ 0.001) but were similar to those in healthy controls. Males with OA and NOA were similar at TVs of 9-11 cm 3 ( P = 0.838), with sensitivity, specificity, Youden index, and area under the curve of 50.0%, 84.2%, 0.34, and 0.662 (95% confidence interval [CI]: 0.502-0.799), respectively, for SWE cut-off of 3.1 kPa; and 94.1%, 79.2%, 0.74, and 0.904 (95% CI: 0.811-0.996), respectively, for RTT cut-off of 1.6 mm. The results showed that RTT performed significantly better than SWE in differentiating OA from NOA in the TV overlap range. In conclusion, ultrasonographic RTT evaluation proved a promising diagnostic approach to differentiate OA from NOA, particularly in the TV overlap range.