Application Value of Multimodal Ultrasound Technology in Microdissection Testicular Sperm Extraction for Idio-pathic Non-Obstructive Azoospermia
Objective To explore the application of multimodal ultrasound including shear wave elastography(SWE),su-perb micro-vascular imaging(SMI)and contrast enhanced ultrasound(CEUS)in guiding microdissection testicular sperm extraction(M-TESE)in idiopathic non-obstructive azoospermia(NOA).Methods A total of 120 idiopathic NOA patients were prospectively enrolled and randomly divided into SWE group,SMI group and CEUS group,with 40 cases in each group.Each group was located and quantitatively analyzed at the maximum and minimum Young's modulus(E)in SWE,the highest and lowest Color Pixel Percentage(CPP)in SMI,and the concentrated and sparse areas in CEUS.Microdissec-tion testicular sperm extraction was performed in the above areas and conventional areas respectively,and the success rate of sperm extraction in each area was compared.Results The sperm extraction rates at the minimum Young's modulus(E)in SWE,the highest Color Pixel Percentage(CPP)in SMI,and the concentrated areas in CEUS were higher than those in conventional areas(P＜0.05).There were significant differences in Young's modulus,CPP and contrast parameters(peak time,average transit time,peak intensity,area under the curve)between the positive site and the negative site(P＜0.05).Young's modulus,CPP and PI of sperm positive sites were(6.49±3.19)kPa,(45.79±1.30)%and(15.84±3.19)/dB,respectively.When the cutoff values of Young's modulus,CPP and PI are 8.84 kPa,45.80%and 15.69/dB respectively,the corresponding AUC is the highest.Conclusion Multimodal ultrasound technology is helpful to improve the success rate of M-TESE sperm extraction.
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