發(fā)布時間：2018-09-10 05:54

【摘要】：【目的】基于組織應(yīng)力分布的超聲彈性成像技術(shù)是一種極具潛力的醫(yī)學(xué)成像方式,已廣泛應(yīng)用在乳腺、甲狀腺、前列腺等疾病的診斷。前期研究表明,超聲彈性成像技術(shù)有可能在評估睪丸占位性病變中起著重要的作用,但是將彈性成像技術(shù),尤其是剪切波彈性成像(Shear Wave Elastography,SWE)技術(shù)應(yīng)用在正常睪丸和附睪中的研究極少。為探討SWE技術(shù)應(yīng)用于正常睪丸和附睪的方法學(xué),我們研究了正常睪丸和附睪SWE成像特點(diǎn),并對雙側(cè)睪丸和附睪丸內(nèi)部不同區(qū)域、睪丸不同切面的SWE彈性模量做了對比研究,同時對影響睪丸和附睪硬度的相關(guān)因素進(jìn)行了初步研究�！痉椒ā亢Y選我院門診110位正常男性受檢者共計220只睪丸,對睪丸和附睪分別進(jìn)行常規(guī)超聲和超聲彈性成像檢查,并獲得SWE聲像圖及彈性模量。首先,對睪丸(包括長軸、短軸切面)和附睪(包括附睪頭、體、尾)依次進(jìn)行二維灰階、彩色多普勒常規(guī)超聲檢查。其次,分別將感興趣區(qū)域(Region Of Interest,ROI)置于雙側(cè)睪丸和附睪同一區(qū)域,以及所有睪丸長軸切面的不同區(qū)域(中心區(qū)域和外周區(qū)域,其中外周區(qū)域包括上極包膜下、下極包膜下、前包膜下和后包膜下)、短軸切面中心區(qū)域、附睪不同區(qū)域(附睪頭、尾),分別測量相應(yīng)區(qū)域的SWE彈性模量。應(yīng)用相應(yīng)的統(tǒng)計學(xué)方法進(jìn)行統(tǒng)計學(xué)分析,以P0.05為差異有統(tǒng)計學(xué)意義。【結(jié)果】正常睪丸和附睪SWE彈性圖像基本呈現(xiàn)均一的藍(lán)色,附睪的SWE彈性模量測值大于正常睪丸SWE彈性模量測值。睪丸長軸切面中心區(qū)域、上極包膜下、下極包膜下、前包膜下、后包膜下,短軸切面中心區(qū)域,SWE彈性模量測值分別為(3.20±0.57)Kpa、(3.94±0.90)Kpa、(3.94±0.97)Kpa、(6.27±1.58)Kpa、(5.96±1.46)Kpa、(3.44±0.51)Kpa。睪丸周邊區(qū)域SWE彈性模量測值大于中心區(qū)域,短軸(中心區(qū)域)切面SWE彈性模量測值大于長軸(中心區(qū)域)切面,睪丸前包膜下SWE彈性模量測值大于后包膜下,而睪丸上、下極包膜下SWE彈性模量測值無明顯差別。關(guān)于影響睪丸和附睪硬度的相關(guān)因素分析,結(jié)果顯示:隨著年齡的增加,睪丸硬度越來越大,而體積對睪丸硬度無明顯影響;年齡對附睪硬度無明顯影響�！窘Y(jié)論】作為一項(xiàng)新的診斷技術(shù),SWE技術(shù)在評估睪丸及附睪組織硬度的應(yīng)用中可獲得相對穩(wěn)定的SWE彈性圖像。睪丸硬度呈中心區(qū)域小而周邊區(qū)域大的分布特點(diǎn),睪丸短軸切面硬度大于長軸切面,睪丸硬度隨年齡的增加而增大。本研究結(jié)論為進(jìn)一步應(yīng)用SWE技術(shù)對陰囊病變的診斷奠定了基礎(chǔ),盡管仍然需要大樣本的臨床研究來驗(yàn)證和支持以上數(shù)據(jù)和結(jié)論,但是SWE技術(shù)作為一種新的成像技術(shù),有望應(yīng)用于臨床評估睪丸硬度以及陰囊相關(guān)疾病的診斷�！灸康摹刻接憫�(yīng)用剪切波彈性成像(Shear Wave Elastography,SWE)技術(shù)在急性附睪炎治療前后的臨床應(yīng)用價值�！痉椒ā亢Y選2016年4月至2017年1月,在我院被診斷為急性附睪炎并接受規(guī)范化治療患者24位,共計25個附睪尾部炎性包塊,于治療前、治療后1周、2周、1月、2月及3月分別記錄炎性包塊的SWE彈性模量、包塊大小及包塊數(shù)量,對比附睪炎性包塊SWE彈性模量變化與其相同時間段內(nèi)大小和數(shù)量的變化�！窘Y(jié)果】治療前,平均硬度(50.15±16.90)KPa,平均大小(5.62±3.62)cm3,炎性包塊25個;治療后1周,平均硬度(43.29±25.55)KPa,平均大小(3.02±2.37)cm3,炎性包塊23個;治療后2周,平均硬度(35.82±23.97)KPa,平均大小(2.0±1.98)cm3,炎性包塊20個;治療后1月,平均硬度(23.42±13.25)KPa,平均大小(1.12±1.58)cm3,炎性包塊13個;治療后2月,炎性包塊2個;治療后3月,炎性包塊全部消失�！窘Y(jié)論】SWE技術(shù)可反映附睪炎性包塊在規(guī)范化治療過程中內(nèi)部組織結(jié)構(gòu)硬度的變化,即隨著療程的進(jìn)展,附睪炎性包塊SWE彈性模量逐漸減低,表明其硬度逐漸變小。
[Abstract]:[Objective] Ultrasound elastography based on tissue stress distribution is a potential medical imaging method, which has been widely used in the diagnosis of breast, thyroid, prostate and other diseases. In order to explore the methodology of applying SWE technique to normal testis and epididymis, we studied the SWE imaging characteristics of normal testis and epididymis, and performed different incisions of testis in different regions of bilateral testis and epididymis. The SWE elastic modulus of the testis and epididymis was studied comparatively, and the related factors affecting the hardness of testis and epididymis were studied preliminarily. First, the testis (including long axis, short axis section) and the epididymis (including the head, body and tail of the epididymis) were examined by two-dimensional gray scale and color Doppler ultrasonography. Secondly, the region of interest (ROI) was placed in the same area of the bilateral testis and epididymis, as well as in different areas (central area and peripheral area) of the long axis section of the testis. The SWE elastic modulus of different regions of the epididymis (head and tail of epididymis) were measured in the peripheral region, including subcapsular, subcapsular, subcapsular, subcapsular, central and short axis section. The SWE elastic images of testis and epididymis were basically uniform blue, and the SWE elastic modulus of epididymis was higher than that of normal testis. The SWE elastic modulus of testis in the central region of long axis section, under epipolar capsule, under epipolar capsule, under anterior capsule, under posterior capsule, and in the central region of short axis section were (3.20.57) Kpa and (3.94.90) Kpa, respectively. Kpa, (3.94 + 0.97) Kpa, (6.27 + 1.58) Kpa, (5.96 + 1.46) Kpa, (3.44 + 0.51) Kpa. The measured values of SWE elastic modulus in the periphery of testis were greater than those in the central region, the measured values of SWE elastic modulus in the short axis (central region) were greater than those in the long axis (central region), the SWE elastic modulus under the anterior capsule of testis was greater than that under the posterior capsule, and SWE elastic modulus in the upper and lower capsule of testis. There was no significant difference in the values of sexual modulus. The results showed that testicular stiffness increased with age, but volume had no significant effect on testicular stiffness. Age had no significant effect on epididymal stiffness. [Conclusion] As a new diagnostic technique, SWE was used to evaluate testicular and epididymal stiffness. Relatively stable SWE elastic images can be obtained in the application of tissue hardness. Testicular hardness is characterized by a small central area and a large peripheral area. The hardness of the short axis section of the testis is greater than that of the long axis section. Testicular hardness increases with age. Large-scale clinical studies are still needed to validate and support these data and conclusions, but SWE, as a new imaging technique, is expected to be used in clinical evaluation of testicular stiffness and scrotal-related diseases. [Objective] To explore the application of Shear Wave Elastography (SWE) in the treatment of acute epididymitis. [Methods] From April 2016 to January 2017, 24 patients with acute epididymitis who received standardized treatment in our hospital were selected and 25 inflammatory masses in the caudal epididymis were recorded before treatment, 1 week, 2 weeks, 1 month, 2 months and 3 months after treatment. The SWE elastic modulus of epididymal inflammatory mass was compared with that of its size and quantity in the same time period. [Results] Before treatment, the average hardness (50.15 65 The average hardness was (35.82 +23.97) KPa, with an average size of (2.0 +1.98) cm 3 and 20 inflammatory masses; the average hardness was (23.42 +13.25) KPa, with an average size of (1.12 +1.58) cm 3 and 13 inflammatory masses at 1 month after treatment; the inflammatory masses were 2 at 2 months and all disappeared at 3 months after treatment. During the course of treatment, SWE elastic modulus of epididymal inflammatory mass decreased gradually, which indicated that the hardness of epididymal inflammatory mass decreased gradually.
【學(xué)位授予單位】：廣州醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.1;R697.22

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 柴啟亮;金佳美;張忠云;詹嘉;陳悅;;聲脈沖輻射力成像對精索靜脈曲張不育患者睪丸的彈性定量研究[J];中國超聲醫(yī)學(xué)雜志;2016年09期

2 吳剛;吳強(qiáng);孔莎;劉銀龍;范志娜;王文偉;袁建軍;;聲輻射脈沖彈性成像技術(shù)在評價睪丸精原細(xì)胞瘤特性中的初步應(yīng)用[J];中國實(shí)用醫(yī)藥;2015年36期

3 曾碧丹;陳菲;羅燕華;邱少東;高思雅;;準(zhǔn)靜態(tài)超聲彈性成像技術(shù)對睪丸及附睪占位性病變的診斷價值[J];現(xiàn)代醫(yī)院;2015年09期

4 黃];姜鑌;劉艷君;翟齊西;卞東林;王學(xué)梅;;實(shí)時剪切波彈性成像技術(shù)定量評價正常成人睪丸、附睪[J];解剖科學(xué)進(jìn)展;2015年03期

5 黃毅斌;端學(xué)軍;胡萍香;朱玉峰;肖小鵬;;精索靜脈曲張不育患者睪丸組織聲脈沖輻射力成像表現(xiàn)與精液質(zhì)量相關(guān)性分析[J];中國醫(yī)藥導(dǎo)刊;2015年S1期

6 黃];姜鑌;王學(xué)梅;劉艷君;翟齊西;卞東林;;實(shí)時剪切波彈性成像技術(shù)在急性睪丸炎預(yù)后評價中的臨床應(yīng)用[J];中國全科醫(yī)學(xué);2015年12期

7 王淑紅;田慧艷;鐘萬;徐坤;周策;高章圈;宗文平;陳拽生;;不孕不育患者泌尿生殖道支原體感染及其藥敏分析[J];中國計劃生育學(xué)雜志;2015年02期

8 趙獻(xiàn)萍;翟虹;趙青;喻勝;段永亮;王彪;;聲觸診組織成像量化技術(shù)評價乳腺腺體彈性與年齡的相關(guān)性研究[J];中國醫(yī)藥指南;2014年18期

9 丁高峰;張盛敏;;實(shí)時超聲彈性成像診斷睪丸良惡性病變的價值[J];現(xiàn)代實(shí)用醫(yī)學(xué);2014年05期

10 張雋;鄧又斌;黃媛;湯喬穎;鄧琪;;探頭掃查平面與肌纖維走行方向夾角對剪切波傳播速度的影響[J];中國醫(yī)學(xué)影像技術(shù);2013年09期

，

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