Differential Diagnostic Value of Trans-scrotal and Rectal Ultrasonography Combined with Serum AMH Detection in Obstructive and Nonobstructive Azoospermia
Objective:To investigate the differential diagnostic value of trans-scrotal and rectal ultrasonography combined with serum anti-Müllerian hormone(AMH)detection in azoospermia.Method:A total of 90 patients with azoospermia admitted to Xianning First People's Hospital from March 2017 to March 2021 were selected,all of whom underwent trans-scrotal and rectal ultrasonography and serum AMH detection,and the patients were divided into obstructive azoospermia(OA)group(n=38)and nonobstructive azoospermia(NOA)group(n=52)according to the results of testicular biopsy.Testicular volume,ultrasonic signs and serum AMH levels were compared between the two groups.The efficacy of trans-scrotal and rectal ultrasonography,serum AMH and combined diagnosis of OA were analyzed by drawing receiver operator characteristic(ROC)curve.Result:The ultrasonographic results showed that the proportion of testicular volume≥12 mL,abnormal ultrasonic signs of epididymis and distal vas deferens in OA group were significantly higher than those in NOA group,the differences were statistically significant(P<0.05).Serum AMH level in OA group was(8.43±2.57)ng/mL,which was significantly higher than(5.58±1.72)ng/mL in NOA group,the difference was statistically significant(P<0.05).ROC curve showed that the area under the curve(AUC)of testicular volume≥12 mL,abnormal ultrasonic signs of epididymis and distal vas deferens(obstruction signs),serum AMH,and ultrasound combined with serum AMH in diagnosing OA were 0.788,0.793,0.881 and 0.964,respectively.Conclusion:Trans-scrotal and rectal ultrasonography combined with serum AMH detection has a high value in identifying OA and NOA.
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