The Correlation Between Sonographic Appearances Of Experimental Testicular Hemodynamic Disorder And The Histological Changes After Reperfusion

Objective: To discuss the relationship between the sonographic appearances of experimentally induced acute unilateral testicular hemodynamic disorder with different degree and the histological structure changes after reperfusion.Methods: 32 white male rabbits were used in the study. The animals were randomly divided into 4 groups: control group (sham operation group) and experimental group A,B and C , with 8 in each . The acute testicular hemodynamic disorder models were established in all groups and the experimental groups were dynamic observed by color Doppler ultrasound (CDU). According to the changes in sonographic appearances of all experimental groups, the ischemic testes in group A showed homogeneous echo and slightly decreased in color Doppler flow signals, in group B showed heterogeneous echo and obviously decreased in color Doppler flow signals, in group C showed radial or in fragmentis low echo area and color Doppler flow signals disappeared, then the testes were reperfusion. The contrast-enhanced ultrasonographic (CEUS) was performed before operation and reperfusion in each group .The time-intensity curves were evaluated by using AxiustTM auto-tracking contrast quantification (ACQ) and the parameters includeβ,arrive time(AT),time-to-peak (TTP),peak-base indensity (PBD),half of declining time (DT/2) were analyzed. After 1 month of breeding, all rabbits were sacrificed and the histological structure changes of ischemic testes were observed. Analysis the correlation between histological structure changes in contrast to the sonographic and CEUS appearances of all groups.Results: The CEUS parametersβ,AT,TTP,PBD,DT/2 of bilateral testes showed no significant difference in all groups before operation(P>0.05). After operation , the CEUS parametersβ,AT,TTP,DT/2 of bilateral testes showed significant difference in group A and B(P<0.05).The parameter PBD of bilateral testes showed no significant difference in group A (P>0.05)but significant difference in group B(P<0.05).The CEUS parametersβ,PBD of the ischemic testes is 0 in group C, which shows significant difference compared with the contralateral testes. In all experimental group, the volume of the ischemic testes after operation for 3 to 5 hours showed significant difference compared with preoperative(P<0.05).After 1month of breeding, compared with the control group, the volume and the Johnsen's score(9.10±0.11 in control group and 8.70±0.39 in group A) of the ischemic testes shows no significant difference in group A(P>0.05),but significant difference in group B(6.01±0.88)(P<0.05) and extremely significant difference in group C(3.16±1.05)(P<0.001).Conclusions:①Sonographic appearances of acute testicular hemodynamic disorder is related to histological structure changes after reperfusion. Ultrasonography is help for the prediction of spermatogenesis function of the ischemic testes after reperfusion.②CEUS has a higher sensitivity and accuracy in reflection the perfusion of the ischemic testes with different degree compared with CDFI.