A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound
Abstract Background Hemodynamic alterations in the spermatic vein are implicated in infertility among patients with varicocele (VC). Contrast-enhanced ultrasound (CEUS), a powerful tool for hemodynamic analysis, remains unexplored for VC. This study aimed to demonstrate the feasibility of using CEUS...
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2025-01-01
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| Series: | Basic and Clinical Andrology |
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| Online Access: | https://doi.org/10.1186/s12610-024-00249-8 |
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| author | Penglin Zou Gaoxiang Fan Zheng Li Yuchen Tao Chao Jia Hongmei Liang Ruhui Tian Qiusheng Shi Jianlin Hu Rong Wu |
| author_facet | Penglin Zou Gaoxiang Fan Zheng Li Yuchen Tao Chao Jia Hongmei Liang Ruhui Tian Qiusheng Shi Jianlin Hu Rong Wu |
| author_sort | Penglin Zou |
| collection | DOAJ |
| description | Abstract Background Hemodynamic alterations in the spermatic vein are implicated in infertility among patients with varicocele (VC). Contrast-enhanced ultrasound (CEUS), a powerful tool for hemodynamic analysis, remains unexplored for VC. This study aimed to demonstrate the feasibility of using CEUS to evaluate spermatic vein hemodynamics in patients with VC and establish a clear correlation between specific hemodynamic patterns and impaired semen parameters. This study included 165 patients with left-sided VC and 50 healthy volunteers. All participants underwent CEUS of the spermatic veins, along with maximum venous diameter and testicular volume measurements and serum sex hormone levels and routine semen analyses. The sperm DNA fragmentation index was measured in 146 patients with VC and 37 healthy controls. Results The analyses revealed four distinct blood flow patterns of the spermatic vein: steady flow, intermittent stasis, intermittent reflux, and filling defect. In healthy spermatic veins, the predominant blood flow patterns included steady flow and intermittent stasis. Spermatic veins with VC exhibited a significant increase in the intermittent reflux and filling defect patterns, with the proportion rising as the clinical grade increased. The four patterns were further grouped into the “steady flow & intermittent stasis” and “intermittent reflux & filling defect” patterns for logistic regression analyses; the intermittent reflux & filling defect pattern was revealed as an independent risk factor for impaired sperm concentration, total sperm counts, progressive motility, morphology, and DNA fragmentation index. Conclusions This study validated the feasibility of CEUS for assessing the hemodynamics of the spermatic vein and established the intermittent reflux & filling defect pattern as an independent predictor of impaired semen parameters. |
| format | Article |
| id | doaj-art-e8d831558a7d463ab7e0371575ddb120 |
| institution | Kabale University |
| issn | 2051-4190 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Basic and Clinical Andrology |
| spelling | doaj-art-e8d831558a7d463ab7e0371575ddb1202025-01-26T12:19:52ZengBMCBasic and Clinical Andrology2051-41902025-01-0135111210.1186/s12610-024-00249-8A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasoundPenglin Zou0Gaoxiang Fan1Zheng Li2Yuchen Tao3Chao Jia4Hongmei Liang5Ruhui Tian6Qiusheng Shi7Jianlin Hu8Rong Wu9Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Reproductive Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Reproductive Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Reproductive Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background Hemodynamic alterations in the spermatic vein are implicated in infertility among patients with varicocele (VC). Contrast-enhanced ultrasound (CEUS), a powerful tool for hemodynamic analysis, remains unexplored for VC. This study aimed to demonstrate the feasibility of using CEUS to evaluate spermatic vein hemodynamics in patients with VC and establish a clear correlation between specific hemodynamic patterns and impaired semen parameters. This study included 165 patients with left-sided VC and 50 healthy volunteers. All participants underwent CEUS of the spermatic veins, along with maximum venous diameter and testicular volume measurements and serum sex hormone levels and routine semen analyses. The sperm DNA fragmentation index was measured in 146 patients with VC and 37 healthy controls. Results The analyses revealed four distinct blood flow patterns of the spermatic vein: steady flow, intermittent stasis, intermittent reflux, and filling defect. In healthy spermatic veins, the predominant blood flow patterns included steady flow and intermittent stasis. Spermatic veins with VC exhibited a significant increase in the intermittent reflux and filling defect patterns, with the proportion rising as the clinical grade increased. The four patterns were further grouped into the “steady flow & intermittent stasis” and “intermittent reflux & filling defect” patterns for logistic regression analyses; the intermittent reflux & filling defect pattern was revealed as an independent risk factor for impaired sperm concentration, total sperm counts, progressive motility, morphology, and DNA fragmentation index. Conclusions This study validated the feasibility of CEUS for assessing the hemodynamics of the spermatic vein and established the intermittent reflux & filling defect pattern as an independent predictor of impaired semen parameters.https://doi.org/10.1186/s12610-024-00249-8Male infertilityVaricoceleContrast-enhanced ultrasoundHemodynamics |
| spellingShingle | Penglin Zou Gaoxiang Fan Zheng Li Yuchen Tao Chao Jia Hongmei Liang Ruhui Tian Qiusheng Shi Jianlin Hu Rong Wu A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound Basic and Clinical Andrology Male infertility Varicocele Contrast-enhanced ultrasound Hemodynamics |
| title | A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound |
| title_full | A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound |
| title_fullStr | A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound |
| title_full_unstemmed | A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound |
| title_short | A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound |
| title_sort | new approach for hemodynamics of varicoceles blood flow patterns based on contrast enhanced ultrasound |
| topic | Male infertility Varicocele Contrast-enhanced ultrasound Hemodynamics |
| url | https://doi.org/10.1186/s12610-024-00249-8 |
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