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- Title
Assessment of the use of contrast enhanced ultrasound in guiding microdissection testicular sperm extraction in nonobstructive azoospermia.
- Authors
Zhang, Shijun; Du, Jing; Tian, Ruhui; Xie, Shaowei; Li, Fenghua; Li, Zheng
- Abstract
<bold>Background: </bold>The aim of this study is to assess the value of contrast-enhanced ultrasound (CEUS) as a new non-invasive approach to locate the testicular area in which spermatogenesis is most likely to be found in non-obstructive azoospermic testes and to evaluate the accuracy of CEUS as a predictor of successful sperm retrieval.<bold>Methods: </bold>CEUS was performed in 120 nonobstructive azoospermia (NOA) patients. Microdissection testicular sperm extraction (M-TESE) was performed on the best and poorest perfusion areas selected by CEUS and on conventional areas.<bold>Results: </bold>In the 187 testicles that underwent M-TESE, the sperm retrieval rates (SRRs) in the best perfusion area and poorest perfusion area over the maximal longitudinal section and conventional area were 63.1, 34.7 and 47.1%. According to receiver operating characteristic (ROC) analysis, the arrival times (AT) ≤27 s, time-to-peak intensity (TTP) ≤45 s, and peak intensity (PI) ≥11 dB were the best predictors of positive sperm retrieval. The location of the best perfusion area was able to guide M-TESE to improve the success rates.<bold>Conclusions: </bold>Testicle CEUS is suggested to be performed in all patients with NOA. If AT≤27 s, TTP ≤ 45 s or PI≥11 dB are found in the best perfusion area, M-TESE is strongly recommended.
- Subjects
SPERM count; SPERMATOGENESIS; TESTIS; CONTRAST-enhanced ultrasound; MICRODISSECTION
- Publication
BMC Urology, 2018, Vol 18, Issue 1, pN.PAG
- ISSN
1471-2490
- Publication type
journal article
- DOI
10.1186/s12894-018-0367-y