The usefulness of elastography in the evaluation and management of adult men with varicocele: A systematic review.

IF 1.3 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology Pub Date : 2021-09-16 eCollection Date: 2021-01-01 DOI:10.1080/2090598X.2021.1964256

Jibril Oyekunle Bello, Kamran Hassan Bhatti, Nazim Gherabi, Joseph Philipraj, Yash Narayan, Georgios Tsampoukas, Nisar Shaikh, Athanasios Papatsoris, Mohamad Moussa, Noor Buchholz

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引用次数: 2

Abstract

Objective: To review the role of elastography in the evaluation and decision-making of adult, infertile men with varicocele.

Methods: A systematic search using the terms (Elastography) AND (Varicocele), (Stiffness) AND (Varicocele), (Elastography) AND (Male infertility) was performed in Pubmed/Medline. Studies reporting a) elastographic characteristics in varicocele-bearing comparing to normal testicles, and b) the correlation of elastography with varicocele grading, parameters of spermatogenesis, and outcomes of varicocele treatment were selected. Exclusion criteria were animal, adolescents, abstracts, and non-English language studies.

Results: In total, 453 articles were identified; 11 eligible studies were selected. Several modalities were used (shear wave elastography, strain elastography, quasistatic ultrasound elastography, acoustic radiation force impulse). Varicocele-bearing testicles have significantly different stiffness and elasticity in comparison to normal and non-varicocele testicles. Although not in full agreement, elastography readings are correlated with semen parameters. Conflicting results were reported regarding grading as most of the studies failed to demonstrate a significant correlation. Shear wave elastography showed a significant correlation with the improvement in semen parameters after varicocelectomy, but the association with pregnancy rates is unknown. Finally, no studies were identified comparing elastography with other modalities.

Conclusions: Elastography can detect changes in the architecture of varicocele-bearing testicles. Although the role of the modality in grading is uncertain, elastography showed a meaningful correlation with spermatogenesis parameters. Importantly, elastography readings could predict the improvement in semen parameters after varicocelectomy which is useful in terms of decision-making in infertile men with varicocele.

Abbreviations: ARFI: acoustic radiation force impulse; CDUS: colour Doppler ultrasonography; DWI: diffusion-weighted imaging; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SWE: shear wave elastography; VC: varicocele.

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弹性成像在成年男性精索静脉曲张的评估和治疗中的应用:一项系统综述。

目的:探讨弹性成像技术在成年不育精索静脉曲张诊断中的应用价值。方法:在Pubmed/Medline中使用术语(Elastography)和(精索静脉曲张)，(刚度)和(精索静脉曲张)，(Elastography)和(男性不育)进行系统搜索。选择了以下研究报告:a)与正常睾丸相比，精索静脉曲张的弹性成像特征;b)弹性成像与精索静脉曲张分级、精子发生参数和精索静脉曲张治疗结果的相关性。排除标准为动物、青少年、摘要和非英语语言研究。结果:共鉴定出453篇;入选了11项符合条件的研究。使用了几种方法(剪切波弹性成像、应变弹性成像、准静态超声弹性成像、声辐射力脉冲)。与正常和非精索静脉曲张睾丸相比，有精索静脉曲张的睾丸具有明显不同的刚度和弹性。虽然不是完全一致，但弹性图读数与精液参数相关。由于大多数研究未能证明显著的相关性，有关评分的报告结果相互矛盾。横波弹性成像显示与精索静脉曲张切除术后精液参数的改善有显著相关性，但与妊娠率的关系尚不清楚。最后，没有研究确定比较弹性成像与其他模式。结论:弹性成像可以检测精索静脉曲张睾丸的结构变化。虽然模式在分级中的作用尚不确定，但弹性成像显示与精子发生参数有意义的相关性。重要的是，弹性成像读数可以预测精索静脉曲张切除术后精液参数的改善，这在精索静脉曲张不育男性的决策方面是有用的。缩写:ARFI:声辐射力脉冲;CDUS:彩色多普勒超声;DWI:弥散加权成像;PRISMA:系统评价和荟萃分析的首选报告项目;SWE:横波弹性;风险投资:精索静脉曲张。

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来源期刊

Arab Journal of Urology UROLOGY & NEPHROLOGY-

CiteScore

2.80

自引率

0.00%

发文量

期刊介绍： The Arab Journal of Urology is a peer-reviewed journal that strives to provide a high standard of research and clinical material to the widest possible urological community worldwide. The journal encompasses all aspects of urology including: urological oncology, urological reconstructive surgery, urodynamics, female urology, pediatric urology, endourology, transplantation, erectile dysfunction, and urinary infections and inflammations. The journal provides reviews, original articles, editorials, surgical techniques, cases reports and correspondence. Urologists, oncologists, pathologists, radiologists and scientists are invited to submit their contributions to make the Arab Journal of Urology a viable international forum for the practical, timely and state-of-the-art clinical urology and basic urological research.