| Objective Under the ultrasound monitoring,the model of testicular torsion/reduction + compartment decompression was established.The postoperative testicular spermatogenic tissue changes and spermatogenic function were used as evaluation criteria to explore the spermatogenic function of testicular compartment decompression after testicular torsion reduction.Protective effects and shear wave elastography(SWE)and contrast-enhanced ultrasound(CEUS)performance.Methods 1.Changes in testicular volume: The volume of the testis in each group was basically the same before operation,and there was no significant difference in the testicular volume between the groups(P>0.05).2 hours and 4 hours after the torsion group I(3.77±0.51cm3,4.27±0.45cm3),T1 group(3.92±0.53cm3,4.44±0.41cm3)and T2 group(3.72±0.48cm3,4.01±0.44cm3)The testicular volume was greater than that of S group(3.06±0.45cm3,3.15±0.40cm3)(P<0.05).There was no significant difference between group I,T1 and T2(P>0.05).Two hours after reperfusion,group I(4.55±0.36cm3),T1 group(5.24±0.44cm3)and T2 group(5.49±0.40cm3)were more than the S group(3.09±0.39cm3)(P<0.01).The T1 group and the T2 group were larger than the I group(P<0.01).There was no significant difference in the testicular volume between the T1 group and the T2 group(P>0.05).After 30 days,the testicular volume of group I(1.39±0.33cm3),T1 group(2.35±0.34cm3)and T2 group(2.49±0.43cm3)was smaller than that of group S(3.22±0.35cm3)(P<0.01),T1 group There was no significant difference between the T1 group and the T2 group(P>0.05).2.Changes in testicular compartment pressure: Before operation,the pressure of the testicular compartment of the test group was basically the same,and there was no significant difference in the pressure of the testicular compartment between the groups(P>0.05).2 hours and 4 hours after the torsion,the testicular compartment pressure group I(21.48±1.01 mm Hg,24.20±1.27 mm Hg),T1 group(20.64±1.28 mm Hg,23.55±1.19 mm Hg)and T2 group(21.81±1.25 mm Hg,23.93±1.47 mm Hg)was greater than S group(11.14±1.29 mm Hg,11.45±1.37 mm Hg)(P<0.01).There was no significant difference between group I,T1 group and T2 group(P>0.05).At 2 hours after reperfusion,the pressure of the testicular compartment of the group I(34.53±1.34 mm Hg)was greater than that of the S group(10.95±1.09 mm Hg),the T1 group(11.43±1.46 mm Hg),and the T2 group(11.53±1.18 mm Hg)(P< 0.01),there was no significant difference between S group,T1 group and T2 group(P>0.05).After 30 days,group I(17.21±1.36 mm Hg),T1 group(13.23±1.36 mm Hg)and T2 group(13.80±1.32 mm Hg)were more than the S group(11.11±1.06 mm Hg)(P<0.01).The T1 group and the T2 group were all smaller than the I group(P<0.01),and the T1 group was not significantly different from the T2 group(P>0.05).3.SWE image performance: The color distribution of the SWE images in the testis of each group was about the same and symmetrical,the testicular capsule area was light green or blue-green,and the testis was blue.There was no significant difference in the Emean value between the testicular parenchyma and testicular capsules before operation(P>0.05).2 hours and 4 hours after the torsion,group I(7.44 ± 1.12 k Pa,8.91 ± 1.16 k Pa),T1 group(7.77 ± 1.11 k Pa,8.92 ± 1.07 k Pa)and T2 group(7.93 ± 1.06 k Pa,9.21 ± 0.96 k Pa)The Emean value of the lateral testis was higher than that of the S group(4.56±0.69 k Pa,4.68±0.81 k Pa)(P<0.05),2 hours and 4 hours after the torsion,group I(39.62±3.06 k Pa,45.90±3.44 k Pa),In the T1 group(40.48±3.40 k Pa,48.07±2.72 k Pa)and the T2 group(40.90±3.54 k Pa,47.20±3.42 k Pa),the Emean value of the lateral testicular capsule area was higher than that of the S group(27.63±3.32 k Pa,28.31±3.64 k Pa).High(P<0.05),there was no significant difference in the Emean value between the testis parenchyma and testicular capsule in group I,T1 and T2(P>0.05).The Emean values of the testicular parenchyma and testicular capsules in group I,T1 and T2 were higher than those in group I,T1 and T2 at 2 hours after torsion(P<0.05).Two hours after reperfusion,the Emean value of the testicular parenchyma and testicular capsule area in group I(10.32±1.06 k Pa,56.41±3.40 k Pa)was higher than that in S group(P<0.01),T1 group,T2 group and S group side.There was no significant difference in Emean between testicular parenchyma and testicular capsule area(P>0.05).Two hours after reperfusion,the Emean value of the testicular parenchyma and testicular capsules in group I was higher than that in group I(P<0.01).At 2 hours after reperfusion,the Emean values of the testicular parenchyma and testicular capsules in the T1 and T2 groups were lower than those in the T1 and T2 groups(P<0.01).After 30 days,the Emean values of the testicular parenchyma and testicular capsules in the S group were not significantly different from those before 30 days(P>0.05),group I(7.37±1.16 k Pa),T1 group(6.02±0.86 k Pa)and T2 group(The Emean value of the testicular parenchyma of the 5.83±0.97 k Pa was higher than that of the S group(P<0.05),the I group(38.44±3.83 k Pa),the T1 group(32.50±2.69 k Pa)and the T2 group(33.64±3.78 k Pa).The Emean value of the lateral testicular capsule area was higher than that of the S group(P<0.05).The Emean value of the testicular parenchyma and the capsule area of the test group was higher than that of the T1 group and the T2 group(P<0.05).The T1 group was compared with the T2 group.There was no significant difference in the Emean value between the testis parenchyma and the capsule area(P>0.05).4.Contrast-enhanced ultrasonography: There was no significant difference in the ultrasound contrast parameters between the groups before operation(P>0.05).After 30 days,there was no significant difference in the contrast-enhanced ultrasound between the S group and the testis(P>0.05).Two hours after reperfusion,the contrast parameters of group I compared with group S,PI((16.28±3.53)10E-5AU),Slope,AUC increased significantly(P<0.01),TP(10.95±1.78s)was significantly shortened(P<0.01),MTT,DT/2(28.36±2.76s)significantly prolonged(P<0.01);T1 group compared with group I angiographic parameters,PI((13.49±2.72)10E-5AU),Slope minus Small(P<0.05),AUC decreased significantly(P<0.01),TP(13.63±2.13s)prolonged(P<0.05),MTT shortened(P<0.05),DT/2(22.99±1.96s)significantly shortened(P<0.01);PI((13.05±2.78)10E-5AU)decreased in the T2 group compared with the I group(P<0.05),Slope and AUC decreased significantly(P<0.01),TP(13.09±)2.89s)prolonged(P<0.05),MTT shortened(P<0.05),DT/2(22.99±3.68s)significantly shortened(P<0.01);there was no significant difference between T1 group and T2 group(P> 0.05).After 30 days,the contrast parameters of group I were significantly lower than those of group S,PI((3.39±0.94)10E-5AU),Slope,AUC decreased significantly(P<0.01),TP(23.21±3.24s),MTT,DT/2(26.08±3.43s)was significantly prolonged(P<0.01);compared with group I in the T1 group,PI((5.08±1.30)10E-5AU),Slope,AUC significantly increased(P<0.01),TP(P<0.01)19.53±4.77s),MTT,DT/2(22.09±4.41s)shortened(P<0.05);T2 group compared with group I contrast parameters,PI((5.48±1.13)10E-5AU),Slope,AUC significantly increased(P<0.01),TP(19.05±2.89s),MTT,DT/2(21.00±2.48s)shortened(P<0.05);there was no significant difference between the T1 group and the T2 group(P>0.05).5.HE staining pathological results: under the light microscope,the spermatogenic cells of the spermatogenic tubules of the testicular tissue of the S group were arranged neatly,and a large number of sperm cells and a small amount of sperm were produced inside the lumen;the number of sperm cells in the group I was significantly reduced.Arrangement disorder,only see a small number of spermatocytes and spermatogonia formation,some visible small sperm cells,testicular interstitial and vascular fibrosis;T1 group and T2 group of spermatogenic spermatogenic cells decreased,arranged disorderly,visible ~ A large number of sperm cells are produced,a small number of spermatozoa can be seen,and a few are only found in spermatogenesis,and the testicular stroma and vascular fibrosis.The Johnsen's scores of the testicular tissues in group I(5.21±1.56),T1 group(7.33±1.07)and T2 group(7.54±1.01)were smaller than those in group S(9.17±0.62)(P<0.01).The Johnsen's scores of the testicular tissues in the T1 group and the T2 group were higher than those in the I group(P<0.01).There was no significant difference in Johnsen's score between the T1 group and the T2 group(P>0.05).6.MDA detection: MDA content in the testis of group I(7.57±0.56nmol/mg prot),T1 group(4.79±0.53nmol/mg prot)and T2 group(5.19±0.63nmol/mg prot)was higher than that of S group(2.62±0.70).nmol/mgprot)increased(P<0.01).The MDA of the testicular tissue of group I was higher than that of T1 group and T2 group(P<0.01).There was no significant difference in MDA content between the testicular tissues of the T1 group compared with the T2 group(P>0.05).7.Apoptosis index(AI): group I(38.58±2.95%),T1 group(15.00±2.89%)and T2 group(14.04±2.28%),the testicular tissue AI was better than the S group(4.46±0.97%).Increased(P<0.01).The AI of the testicular tissue of group I was higher than that of T1 group and T2 group(P<0.01).There was no significant difference in AI between the T1 group and the T2 group(P>0.05).Conclusions 1.Testicular compartment syndrome(TCS)runs through the process of testicular torsion and ischemia-reperfusion injury after reduction.Testicular compartment decompression is the direct cause of TCS,which directly reduces testicular compartment pressure and relieves TCS.Damage to testicular tissue has a protective effect on spermatogenic function.2.At different stages of TCS,the state of microcirculation function will change differently,and the corresponding ultrasound contrast will have different performance.3.At different stages of TCS,the hardness of testicular tissue will also change,and the corresponding shear wave elastography will also have different performance. |
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