Gao Sikang, Yang Jun, Chen Dong, Min Xiangde, Fan Chanyuan, Zhang Peipei, Wang Qiuxia, Li Zhen, Cai Wei
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
J Imaging. 2023 Sep 8;9(9):182. doi: 10.3390/jimaging9090182.
Microdissection testicular sperm extraction (mTESE) is the first-line treatment plan for nonobstructive azoospermia (NOA). However, studies reported that the overall sperm retrieval rate (SRR) was 43% to 63% among men with NOA, implying that nearly half of the patients fail sperm retrieval. This study aimed to evaluate the diagnostic performance of parameters derived from diffusion tensor imaging (DTI) in predicting SRR in patients with NOA. Seventy patients diagnosed with NOA were enrolled and classified into two groups based on the outcome of sperm retrieval during mTESE: success (29 patients) and failure (41 patients). Scrotal magnetic resonance imaging was performed, and the DTI parameters, including mean diffusivity and fractional anisotropy, were analyzed between groups. The results showed that there was a significant difference in mean diffusivity values between the two groups, and the area under the curve for mean diffusivity was calculated as 0.865, with a sensitivity of 72.2% and a specificity of 97.5%. No statistically significant difference was observed in fractional anisotropy values and sex hormone levels between the two groups. This study demonstrated that the mean diffusivity value might serve as a useful noninvasive imaging marker for predicting the SRR of NOA patients undergoing mTESE.
显微切割睾丸取精术（mTESE）是治疗非梗阻性无精子症（NOA）的一线治疗方案。然而，有研究报道，NOA患者的总体取精成功率（SRR）为43%至63%，这意味着近一半的患者取精失败。本研究旨在评估扩散张量成像（DTI）衍生参数在预测NOA患者SRR方面的诊断性能。纳入70例诊断为NOA的患者，并根据mTESE期间的取精结果将其分为两组：成功组（29例）和失败组（41例）。进行阴囊磁共振成像检查，并分析两组之间的DTI参数，包括平均扩散率和各向异性分数。结果显示，两组之间的平均扩散率值存在显著差异，平均扩散率的曲线下面积计算为0.865，敏感性为72.2%，特异性为97.5%。两组之间的各向异性分数值和性激素水平未观察到统计学上的显著差异。本研究表明，平均扩散率值可能是预测接受mTESE的NOA患者SRR的有用无创成像标志物。
