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Sudan University of Science and Technology College of Graduate Studies بسم هللا الرحمن الرحيم Sudan University of Science and Technology College of Graduate Studies Measurement of Seminal Vesicles Diameter among Adult Sudanese Using Ultrasonography قياس قطر الحويصﻻت المنوية الطبيعي لدي السودانيين البالغين باستخدام الموجات فوق الصوتية A thesis Submitted for Partial fulfillment for the Requirement of the M.Sc. Degree in Medical Diagnostic Ultrasound By: Mohammed Eltaj Abdalaziz Ibrahim Supervisor: Dr. Ahmed Mustafa Abukonna 2020 اﻵية بِ َسـ ِم اٌ ِهلل الـ َرحـم ِن ال َر ِحـيـ م I Dedication ➢ To my parents who have never failed to give me financial and moral support, for giving all my need during the time I developed my stem. ➢ To my brothers and sisters, who have never left my side. ➢ To my cute little boy and girls ➢ To my wife for understanding and patience ➢ To my friends for their help and support. ➢ Finally, ask Allah to accept this work and add it to my good works. II Acknowledgement My acknowledgements and gratefulness at the beginning and at end to Allah who gave us the gift of the mind and give me the strength and health to do this project work until it done completely, the prayers and peace be upon the merciful prophet Mohamed. I would like to give my grateful thanks to my supervisor Dr. Ahmed Mustafa Abukonna who helped and encouraged me in every step of this study. III Abstract This study was conducted in Khartoum State in Alnhda Reference Medical Center during the period from January (2019) to October (2019). The problem of the study there is no previous studies include measurements of the normal seminal vesicle’s diameter in adult Sudanese. The objective of this study was to establish standard measurements of the seminal vesicles’ diameter in normal adults Sudanese by trans-abdominal ultrasound in order to find measurement range related to age, married status and prostate volume. This study was cross sectional descriptive study where the data were collected from (80) Sudanese adult male using data collecting sheet. The results showed the average diameter of the right seminal vesicles (10.22 ± 2.84) mm and average diameter of the left seminal vesicles (10.29 ± 2.88) mm. The range values of the right seminal vesicle’s diameter (4mm - 21.5 mm) and the range values of the left seminal vesicle )4mm - 22.5 mm( .The study showed that, there was no relationship between the patient's age with right and left vesicle diameters. Also, the study found out that the right and left vesicle diameters wasn't affected by the married status of the patients among these populations. Also, there is no relationships between the prostate volumes with right and left vesicle diameters but there was moderate positive relationship between prostate volume and patient age (R2= 0.53 and P value =0.000). The normal seminal vesicle has low level echogenicity (100%) and homogenous in texture (100 %). The study recommended that future research studies should be done with expanding period of time and include more sample data for precise and accurate results. IV المستخلص أجريت هذه الدراسة بمركز النهضة الصحي المرجعي في وﻻية الخرطوم في الفترة من يناير )2019( وحتى أكتوبر )2019(. تمثلت مشكلة البحث في عدم وجود دراسات سابقة تشمل قياسات قطر الحويصﻻت المنوية عند السودانيين البالغين كما هدفت هذه الدراسة الي قياس قطر الحويصﻻت المنوية لدى السودانيين البالغين باستخدام الموجات فوق الصوتية والمقارنة م ع عمرالمري ض والحالة اﻻجتماعية وحجم البروستاتا. هذه الدراسة مقطعية عرضية وصفية حيث جمعت البيانات من )80( ذكر سوداني بالغ من سن )18( سنة الي )60( سنة ومتوسط اﻻعمار 40.4 سنة باستخدا م ورقة جمع البيانات. اظهرت الدراسة ان متوسط قطر الحويصﻻت المنوية اليمني كانت )2.84 ± 10.22 ملم.( و أن متوسط قطر الحويصﻻ ت المنوية اليسر ى كانت )2.88 ± 10.29ملم(. مدى قطر الحويصﻻت المنوية اليمنى يتراوح بي ن)4 – 21.5 ملم( وان مدى قطر الحويصﻻت المنوية اليسرى )4 - 22.5 ملم( أظهرت الدراسة انه ليس هنالك عﻻقة بين عمر المريض و قطر الحويصﻻت المنوية و ا نه كذلك ليس هنالك عﻻقة بين الحالة اﻻجتماعية ) متزوج أو عازب ( و قطر الحويصﻻت المنوية كذلك أوجدت هذه الدراسة أنه ليس هنالك عﻻقة بين حجم البروستاتا و قطر الحويصﻻت المنوية وأخيرا أوضحت هذه الدراسة إن الحويصﻻت المنوية الطبيعية تظهر متجانسة . توصي هذه الدراسة بضرورة إجراء دراسات بحثيه أخرى يتم فيها توسيع الفترة وتشمل بيانات أكثر للحصول على نتائج أكثر دقة . V List of contents Content Page NO I اﻵية Dedication II Acknowledgement III Abstract [English] IV Abstract [Arabic] V Table of contents VI List of tables IX List of figures X List of abbreviations XI Chapter One: Introduction 1.1 Introduction 1 1.2 Problem of the study 3 1.3 Objectives 3 1.3.1 General objectives 3 1.3.2 Specific objectives 3 1.4 Significance of the study 4 1.5 Overview of the study 4 Chapter Two: Literature Review and Background Studies 2.1 seminal vesicle anatomy 5 2.1.1 seminal vesicles development 5 2.1.2 Shape and location 6 2.1.3 Structure of seminal vesicles 7 2.1.4 Relations of the seminal vesicles 8 2.1.5 Blood Supply 8 VI 2.1.6 Lymph Drainage 8 2.2 Seminal vesicles Function 9 2-3Prostate anatomy 9 2-3-1Prostatic urethra 9 2-3-2 Periurethral glands 10 2-3-3 Verumontanum 10 2-3-4Blood supply of the prostate 11 2-3-5Function of the prostate 11 2-4Vas Deferens 12 2-5Ejaculatory Ducts 12 2-6 Ultrasound physics 12 2-6-1 Ultrasound Interaction with Tissue 13 2-6-2 Angle of Incidence 13 2-6-3 Attenuation 14 2-6-4 B Mode imaging Controls 15 2-6-4-1 Depth/F.O.V. Control 15 2-6-4-2 Gain 15 2-6-4-3 T.G.C 15 2-6-4-4 Power or Output Control 15 2-6-4-5 Dynamic Range 16 2-6-4-6 Focal Zones 16 2-6-4-7 Frequency 16 2-7seminal vesicles sonogram 17 2-7-2 Ultrasound techniques 17 2-8pathology of seminal vesicles 17 2.8.1 Inflammation 17 VII 2.8.2 Agenesis 18 2.8.3. Cysts 18 2.8.4 Cancer 18 2.9 Previous studies 19 Chapter Three: Methodology 3.1 Study design 20 3.2 Duration and area of the study 20 3.3 Sample size 20 3.4 Inclusion criteria 20 3.5 exclusion criteria 20 3.6 Data collection and instrumentation 20 3.6.1 Equipment used 21 3.6.2 Technique 22 3.6.3 Data collection 23 3.7 Method of data analysis 24 3.8 Ethical consideration 24 Chapter Four: The Results 4. Results 25 Chapter Five: Discussion, Conclusion and Recommendations 5.1 Discussion 32 5.2 Conclusion 33 5.3 Recommendations 34 References Appendices VIII List of tables Table Title Page 2.1 Percentage reflection of ultrasound at boundaries 13 4.1 shows age group frequency and percent. 25 4.2 shows the married status frequency and percent. 26 4.3 Model expressing descriptive statistics of right and left vesicles 27 diameter 4.4 Model correlation test expressing the relationship between the 28 patient's age and right seminal vesicle diameter 4.5 Model correlation test expressing the relationship between the 29 patient's age and left seminal vesicle diameter 4.6 shows distributions of two groups (Married and un married) with 29 their means and standard deviations calculated 4.7 t-test for Equality of Means of two groups 29 4.8 shows distributions of two groups (Married and un married) with 30 their means and standard deviations calculated 4.9 t-test for Equality of Means of two groups: for male 30 4.10 Model correlation test expressing the relationship between the 31 prostate volume with right and left seminal vesicles diameter 4.11 Model expressing frequency distribution of seminal vesicle texture 31 and echogenicity IX List of Figures Figure Figure name Page No. No. 2.1 shows the seminal vesicles and vas deferens both end into ejaculatory 6 duct that ends in Verumontanum 2.2 Shows Seminal vesicles. Through a well distended bladder 17 2.3 Shows Bilateral dilated seminal vesicles. 18 2.4 Shows Unilateral agenesis of left seminal vesicle and vas deferens (V). 19 2.5 Unilateral right seminal vesicle cyst (C); transvesical scan; LSV. 20 2.6 Stage T3C (parasagittal view) cancer (T) extending (arrows) into the 20 seminal vesicles (SV) 4.1 Shows age group frequency and percent. 25 4.2 pie chart shows the married status percent 26 4.3 Scatter plot shows the relationship between c and right vesicle 27 diameter. 4.4 Scatter plot shows the relationship between patient's age and left 28 vesicle diameter. X List of Abbreviations SV Seminal vesicles RT Right LT Left BPH Benign prostatic hyperplasia BMI Body mass index DR Dynamic range ROI Region of interest SNR Signal to noise ratio SPSS Statistical package for the social sciences TGC Time gain compensation UCL Upper confidence limit XI Chapter One Introduction Chapter One Introduction 1.1 Introduction With The rapid advances of medical imaging and computer technologies, Sonography has been widely applied to the abdominal organs in order to benefit and or replace other more complicated and invasive examinations, Sonography is very convenient and simple for the examination of male reproductive system (Wiley-KT et al., 2010). However, there are limited literatures concerning its application for the measurement of seminal Vesicles, which important to exclude many diseases related to pathological and obstructive condition which cause change in the diameter of the seminal vesicles however the seminal vesicle diameter is better than the volume because it is easy to measure and give us accurate result which importance to exclude the pathology from the normal.
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