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目的:探讨放射性核素阴囊血池显像技术(RSS)诊断精索静脉曲张(Vc)及亚临床型精索静脉曲张(SVc)的指标筛选及其临床价值。方法:选取临床主诉及病史提示精索静脉曲张或(和)有不育病史的患者39例,分别接受彩色双功能多普勒血流显像(CDFI)和RSS检查,RSS各指标与CDFI所测量内径呈线性相关,以1.8mm为诊断标准,做RSS各指标ROC曲线分析。结果:阴囊计数与大血管计数之比曲线下面积为0.807(患侧阴囊计数与健侧阴囊计数比曲线下面积为0.523,阴囊计数与软组织计数之比曲线下面积为0.403);阴囊计数与大血管计数比值大于0.63为界可诊断精索静脉曲张,其灵敏度为86%,特异度为62%;同时做特征性感兴趣区发现单侧精索静脉曲张曲线(SVc)呈特异性的“倒V”波,双侧精索静脉曲张曲线(DVc)呈特异的“M”波。结论:RSS技术是诊断临床型及亚临床型的Vc简单、安全、有效的无创方法,以0.63为界诊断精索静脉曲张,结合特异性的SVC及DVC定性图像分析对于提高核素阴囊血池显像的诊断价值具有极其重要的意义。
Objective: To explore the index screening and clinical value of radionuclide scintigraphy and blood pool imaging (RSS) in diagnosis of varicocele (Vc) and subclinical varicocele (SVc). Methods: Thirty-nine patients with varicocele and / or history of infertility were selected according to their clinical features and medical history. Color flow Doppler flow imaging (CDFI) and RSS were performed respectively. The relationship between RSS and CDFI Measuring the diameter was linearly related to 1.8mm for the diagnostic criteria, RSS ROC curve analysis of each indicator. Results: The area under the curve between scrotal and macroscopical counts was 0.807 (the area under curve of ipsilateral scrotum and contralateral scrotal was 0.523, and the area under the curve of scrotal and soft tissue counts was 0.403) Vascular count ratio greater than 0.63 for the diagnosis of infertile varicocele, the sensitivity was 86%, specificity was 62%; at the same time do characteristic regions of interest found unilateral varicocele curve (SVc) was specific V “wave, bilateral varicocele curve (DVc) was a specific ” M "wave. Conclusion: The RSS technique is a simple, safe and effective noninvasive method to diagnose Vc in clinical and subclinical types. The diagnosis of varicocele with a cutoff of 0.63 combined with specific SVC and DVC qualitative image analysis is of great value in improving the scrotal blood pool The diagnostic value of imaging is extremely important.