The Value of Sonoelastography Scores and the Strain Ratio In Differential Diagnosis of Azoospermia

摘要

Purpose: We evaluated the diagnostic performance of real-time elastography for differentiating nonobstructive from obstructive azoospermia. Materials and Methods: We evaluated 1,192 testes, including 584 with nonobstructive azoospermia, 408 with obstructive azoospermia and 200 controls, from men with a mean ± SD age of 30 ± 5 years. Two radiologists evaluated the testes using a 5-degree elastography score system. The strain ratio was calculated on line. Of 156 azoospermic testes 78 were diagnosed by bilateral testicular biopsy for diagnostic purposes or sperm harvesting.Results: In our software system a score of 3 indicated average strain, and scores 4 and 5 indicated low strain. Average or low strain (score 3 to 5) was seen in 477 of 584 testes with nonobstructive azoospermia (81.7%). This rate was significantly higher than the rate in obstructive azoospermic and control testes (68 of 408 or 16.3% and 30 of 200 or 15.0%, p <0.001). The strain ratio significantly differed for nonobstructive and obstructive azoospermia (median 0.490 and 0.340, Z = -20.560, p <0.001).Conclusions: Real-time elastography is a promising imaging method with great potential for the differential diagnosis of azoospermia.