Application of contrast-enhanced ultrasound in the diagnosis of tuberous vas deferens tuberculosis

Abstract

Background: To assess the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of tuberous vas deferens tuberculosis (VD TB) and improve the positive diagnostic rate of VD TB.

Methods: CEUS and routine ultrasound (US) images of 17 patients with tuberous VD TB confirmed by surgery, pathology, or laboratory semen examination were retrospectively analyzed and summarized, and the positive rates of both imaging techniques were compared.

Results: The 19 VD lesions of the 17 patients were divided into two types according to the CEUS findings: Type I and Type II, and type II was divided into Types IIa, IIb, and IIc. Of the nodules with transverse diameters > 1 cm, 100% presented as type II. Of the nodules with transverse diameters < 1 cm, 37.5% (3/8) presented as type I and 62.5% (5/8) presented as type II. The sonographic manifestations of tuberous VD TB were hypoechoic and mixed echoic. The positive diagnostic rate was 89.5% for CEUS and 68.4% for US, but the difference was not significant (χ² = 2.533; P = 0.111).

Conclusions: CEUS was able to show the blood supply characteristics of tuberous VD TB, the internal necrosis of nodules was more easily observed by CEUS than by routine US, which is helpful for the diagnosis of tuberous VD TB.

Keywords: Contrast-enhanced ultrasound; Male infertility; Reproductive system; Tuberculosis; Vas deferens.

Fig. 1

A 31-year-old male with tuberous vas deferens (VD) tuberculosis. The VD wall is thickened with two mixed echo-type nodules showing local enlargement (white arrow)

Fig. 2

A 43-year-old male with tuberous vas deferens tuberculosis (VD TB). A Routine ultrasonography of a VD TB lesion (white arrow). B Contrast-enhanced ultrasonography of a VD TB lesion showing homogeneous enhancement (white arrow) (type I)

Fig. 3

A 33-year-old male with tuberous vas deferens tuberculosis. A Routine ultrasonography showing a mixed echo-type lesion (coarse arrow), B Contrast-enhanced ultrasonography showing septal enhancement of the lesion (fine arrow), visible inside the irregular areas, not the enhanced area (type IIa)

Fig. 4

A 45-year-old male with tuberous vas deferens tuberculosis. A Routine ultrasonography showing a low-echo-type lesion (coarse arrow). B Contrast-enhanced ultrasonography showing heterogeneous enhancement with ring enhancement of a nodule (the small arrow shows a nodule-in-nodule) (Type IIc)