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

Yıl 2023, Cilt: 20 Sayı: 3, 612 - 617, 31.12.2023
https://doi.org/10.35440/hutfd.1377085

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.

Kaynakça

  • 1. Ammar T, Sidhu PS, Wilkins CJ. Male infertility: the role of imaging in diagnosis and management. Br J Radiol 2012; 85 Spec No 1: S59-68.
  • 2. Chaturvedi P, Insana MF, Hall TJ. Ultrasonic and elasticity imaging to model disease-induced changes in soft-tissue structure. Med Image Anal 1998; 2(4): 325-38.
  • 3. Arai T, Kitahara S, Horiuchi S, Sumi S, Yoshida K. Relation-ship of testicular volume to semen profiles and serum hormone concentrations in infertile Japanese males. Int J Fertil Womens Med 1998; 43(1): 40-7.
  • 4. Bujan L, Mieusset R, Mansat A, Moatti JP, Mondinat C, Pontonnier F. Testicular size in infertile men: relationship to semen characteristics and hormonal blood levels. Br J Urol 1989; 64(6): 632-7.
  • 5. MacLeod J, Wang Y. Male fertility potential in terms of semen quality: a review of the past, a study of the pre-sent. Fertil Steril 1979; 31(2): 103-16.
  • 6. Aigner F, De Zordo T, Pallwein-Prettner L, et al. Real-time sonoelastography for the evaluation of testicular lesions. Radiology 2012; 263(2): 584-9.
  • 7. Zhang X, Lv F, Tang J. Shear wave elastography (SWE) is reliable method for testicular spermatogenesis evaluation after torsion. Int J Clin Exp Med 2015; 8(5): 7089-97.
  • 8. Li M, Du J, Wang ZQ, Li FH. The value of sonoelastography scores and the strain ratio in differential diagnosis of azo-ospermia. J Urol 2012; 188(5): 1861-6.
  • 9. D'Anastasi M, Schneevoigt BS, Trottmann M, Crispin A, Stief C, Reiser MF, Clevert DA. Acoustic radiation force impulse imaging of the testes: a preliminary experience. Clin Hemorheol Microcirc 2011; 49(1-4): 105-14.
  • 10. Juul S, Group TEISS, Karmaus W, Group TEISS, Olsen J, Group TEISS. Regional differences in waiting time to pregnancy: pregnancy-based surveys from Denmark, France, Germany, Italy and Sweden. Human Reproduction 1999; 14(5): 1250-4.
  • 11. Handelsman Dj, Staraj S. Testicular Size: The Effects of Aging, Malnutrition, and Illness. 1985; 6(3): 144-51.
  • 12. Mahmoud AM, Goemaere S, El-Garem Y, Van Pottelbergh I, Comhaire FH, Kaufman JM. Testicular Volume in Rela-tion to Hormonal Indices of Gonadal Function in Commu-nity-Dwelling Elderly Men. The Journal of Clinical Endocri-nology & Metabolism 2003; 88(1): 179-84.
  • 13. Aksglaede L, Skakkebaek NE, Almstrup K, Juul A. Clinical and biological parameters in 166 boys, adolescents and adults with nonmosaic Klinefelter syndrome: a Copenha-gen experience. Acta Paediatr 2011; 100(6): 793-806.
  • 14. Cerilli LA, Kuang W, Rogers D. A practical approach to testicular biopsy interpretation for male infertility. Arch Pathol Lab Med 2010; 134(8): 1197-204.
  • 15. Yavuz A, Yokus A, Taken K, Batur A, Ozgokce M, Arslan H. Reliability of testicular stiffness quantification using shear wave elastography in predicting male fertility: a prelimi-nary prospective study. Med Ultrason 2018; 20(2): 141-7.

İnfertil Hastalarda Testis Arfi Elastografi Değerlerinin Sperm Sayıları İle İlişkisi

Yıl 2023, Cilt: 20 Sayı: 3, 612 - 617, 31.12.2023
https://doi.org/10.35440/hutfd.1377085

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.

Etik Beyan

Gaziantep üniversitesinden etik kurul onayı alınmış olup çalışma Helsinki bildirgesi yönetmeliğine uygun olarak yürütülmüştür.

Destekleyen Kurum

yok

Kaynakça

  • 1. Ammar T, Sidhu PS, Wilkins CJ. Male infertility: the role of imaging in diagnosis and management. Br J Radiol 2012; 85 Spec No 1: S59-68.
  • 2. Chaturvedi P, Insana MF, Hall TJ. Ultrasonic and elasticity imaging to model disease-induced changes in soft-tissue structure. Med Image Anal 1998; 2(4): 325-38.
  • 3. Arai T, Kitahara S, Horiuchi S, Sumi S, Yoshida K. Relation-ship of testicular volume to semen profiles and serum hormone concentrations in infertile Japanese males. Int J Fertil Womens Med 1998; 43(1): 40-7.
  • 4. Bujan L, Mieusset R, Mansat A, Moatti JP, Mondinat C, Pontonnier F. Testicular size in infertile men: relationship to semen characteristics and hormonal blood levels. Br J Urol 1989; 64(6): 632-7.
  • 5. MacLeod J, Wang Y. Male fertility potential in terms of semen quality: a review of the past, a study of the pre-sent. Fertil Steril 1979; 31(2): 103-16.
  • 6. Aigner F, De Zordo T, Pallwein-Prettner L, et al. Real-time sonoelastography for the evaluation of testicular lesions. Radiology 2012; 263(2): 584-9.
  • 7. Zhang X, Lv F, Tang J. Shear wave elastography (SWE) is reliable method for testicular spermatogenesis evaluation after torsion. Int J Clin Exp Med 2015; 8(5): 7089-97.
  • 8. Li M, Du J, Wang ZQ, Li FH. The value of sonoelastography scores and the strain ratio in differential diagnosis of azo-ospermia. J Urol 2012; 188(5): 1861-6.
  • 9. D'Anastasi M, Schneevoigt BS, Trottmann M, Crispin A, Stief C, Reiser MF, Clevert DA. Acoustic radiation force impulse imaging of the testes: a preliminary experience. Clin Hemorheol Microcirc 2011; 49(1-4): 105-14.
  • 10. Juul S, Group TEISS, Karmaus W, Group TEISS, Olsen J, Group TEISS. Regional differences in waiting time to pregnancy: pregnancy-based surveys from Denmark, France, Germany, Italy and Sweden. Human Reproduction 1999; 14(5): 1250-4.
  • 11. Handelsman Dj, Staraj S. Testicular Size: The Effects of Aging, Malnutrition, and Illness. 1985; 6(3): 144-51.
  • 12. Mahmoud AM, Goemaere S, El-Garem Y, Van Pottelbergh I, Comhaire FH, Kaufman JM. Testicular Volume in Rela-tion to Hormonal Indices of Gonadal Function in Commu-nity-Dwelling Elderly Men. The Journal of Clinical Endocri-nology & Metabolism 2003; 88(1): 179-84.
  • 13. Aksglaede L, Skakkebaek NE, Almstrup K, Juul A. Clinical and biological parameters in 166 boys, adolescents and adults with nonmosaic Klinefelter syndrome: a Copenha-gen experience. Acta Paediatr 2011; 100(6): 793-806.
  • 14. Cerilli LA, Kuang W, Rogers D. A practical approach to testicular biopsy interpretation for male infertility. Arch Pathol Lab Med 2010; 134(8): 1197-204.
  • 15. Yavuz A, Yokus A, Taken K, Batur A, Ozgokce M, Arslan H. Reliability of testicular stiffness quantification using shear wave elastography in predicting male fertility: a prelimi-nary prospective study. Med Ultrason 2018; 20(2): 141-7.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Radyoloji ve Organ Görüntüleme
Bölüm Araştırma Makalesi
Yazarlar

Cihad Varol 0000-0003-4639-6066

Hale Çolakoğlu Er 0000-0002-5210-734X

Mehmet Demir 0000-0002-5031-6324

Erken Görünüm Tarihi 18 Aralık 2023
Yayımlanma Tarihi 31 Aralık 2023
Gönderilme Tarihi 16 Ekim 2023
Kabul Tarihi 11 Aralık 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 20 Sayı: 3

Kaynak Göster

Vancouver Varol C, Çolakoğlu Er H, Demir M. İnfertil Hastalarda Testis Arfi Elastografi Değerlerinin Sperm Sayıları İle İlişkisi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(3):612-7.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty