The Relationship between Testis Arfi Elastography Values and Sperm Count in Infertile Patients

Öz

Background: The aim of this prospective study was to determine the relationship between testicular shear wave elastography (SWE) and sperm count in infertile male patients and to evaluate diagnostic performance. Materials and Methods: The study was carried out with 113 patients over 18 years of age who were diagnosed as infertility.All patients underwent US examination and virtual touch tissue imaging measu-rement (VTIQ) SWE examination. A total of 6 measurements were made in each testis. Volume measu-rements of testes were calculated with US examination. Patients were evaluated for varicocele using color Doppler ultrasonography Results: Right and left testis volume values in azoospermia patients found statistically different and lower than other groups(p=0,001).The mean SWE values in all zones were significantly higher in azoo-spermia patients compared to the other groups (p=0.001).Moderate positive correlation was found between sperm count and mean volume (r =0.545, p =0.001).Negative correlation was found between sperm count and mean SWE (r =-0.429, p = 0.001).There was a moderate negative relationship between mean volume and mean SWE (r =-0.590, p =0.001). Using ROC analysis between normal sperm and azospermia patients, the cut-off value was 2.06 m/sec.sensitivity 72% specificity was measured 87.88% (p<0,001; AUC=0,837; Sensitivity= 72,00% (95% GA 46,5-85,1); Specifity=87,88% (95% GA 81,5-95,2). Using ROC analysis between the azoospermia patient group and the oligospermia patient group, the cut-off point was 2.04m/sec. For differentiating azoospermia and oligospermia patients groups, the sensitivity (sensitivity) was 72% and the specifity was 83.33% (p<0,001; AUC=0,789; Sensitivity= 72,00% (95% GA 46,5-85,1); Specifity=83,33% (95% GA 81,5-95). Conclusions: SWE is a noninvasive method for the evaluation of testicular parenchyma in male patients whohave infertility and may provide helpful information in addition to gray scale and RDUS.

Anahtar Kelimeler

• Infertility
• testis
• shear wave ultrasonography
• ultrasound

İnfertil Hastalarda Testis Arfi Elastografi Değerlerinin Sperm Sayıları İle İlişkisi

Öz

Amaç: Bu prospektif çalışmanın amacı infertil erkek hastalarda shear wave elastografinin (SWE) sperm sayısı ile ilişkisini saptamak ve tanısal performansının değerlendirilmesidir. Materyal ve Metod: Çalışma infertilite tanısı almış ve semen analizi yapılmış 113 hasta ile yapılmıştır. Tüm hastalara US incelemesi ve virtual touch tissue imaging quantification (VTIQ) kullanılarak SWE incelemesi yapıldı. Her testiste toplam 6 ölçüm yapıldı.US inceleme ile testislerin hacim ölçümleri yapıldı. Bulgular: Azospermi hastalarında sağ ve sol testis volüm değerleri diğer gruplardan istatistiksel olarak farklı ve düşük değerde bulunmuştur(p=0,001). Azospermi hastalarında tüm zonlarda ve ortalama SWE değerleri diğer gruplara göre anlamlı yüksek bulunmuştur(p=0,001). Sperm sayısı ile ortalama volüm arasında pozitif yönde orta şiddette bir ilişki saptanmıştır (r=0,545, p=0,001). Sperm sayısı ile ortalama SWE arasında negatif yönde orta şiddette bir ilişki saptanmıştır (r=-0,429, p=0,001). Ortalama volüm ile ortalama SWE arasında negatif yönde orta şiddette bir ilişki saptanmıştır (r=-0,590, p=0,001). Sperm sayısı normal hasta grubu ile azospermi hastaları arasında yapılan ROC analizinde kesim değeri 2,06 m/sn olup sensivite (duyarlılık) %72 spesivite(özgüllük) %87,88 ölçülmüştür. (p<0,001; EAA=0,837; Sensitivite= 72,00% (95% GA 46,5-85,1); Spesivite=87,88% (95% GA 81,5-95,2). Azospermi hasta grubu ile oligospermi hasta grubu arasında yapılan ROC analizinde kesim noktası 2,04 m/sn olarak belirlenmiştir. Buna göre yapılan değerlendirmede sensivite %72 spesivite %83,33 ölçülmüştür. (p<0,001; EAA=0,789; Sensitivite= 72,00% (95% GA 46,5-85,1); Spesivite=83,33% (95% GA 81,5-95). Sonuç: İnfertilite şikayetiyle başvuran erkek hastalarda testis parankiminin değerlendirilmesinde, SWE invaziv olmayan bir yöntem olup gri skala ve RDUS tetkiklerine ek yararlı bilgiler sağlayabilir.

Anahtar Kelimeler

• infertilite
• testis
• shear wave elastografi
• ultrason

Kaynakça

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