Department of Clinical Radiology, School of Health Sciences, Faculty of Medicine, University of Ioannina, University Campus, 45110, Ioannina, Greece.
Department of Medical Physics, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45110, Ioannina, Greece.
Abdom Radiol (NY). 2024 Dec;49(12):4543-4555. doi: 10.1007/s00261-024-04457-8. Epub 2024 Jun 28.
To assess the role of 3.0 T Diffusion Tensor Imaging (DTI) and Fiber Tractography (FT) of the testes in the work-up of nonobstructive azoospermia (NOA).
This prospective study included consecutive NOA men and controls. A 3.0 T scrotal MRI was performed, including DTI. The testicular apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated. FT reconstructions were created. The Kruskal-Wallis test, followed by pairwise comparisons, assessed differences in testicular ADC and FA between NOA histologic phenotypes (group 1: hypospermatogenesis; group 2: maturation arrest; and group 3: Sertoli cell-only syndrome) and normal testes. The Mann-Whitney-U test compared ADC and FA between NOA testes with positive and negative sperm retrieval. Visual assessment of the testicular fiber tracts was performed. Fiber tracts fewer in number, of reduced thickness, disrupted and/or disorganized were considered "abnormal". Chi-square tests and binary logistic regression analysis assessed variations in testicular fiber tracts morphology.
Twenty-nine NOA men (mean age: 39 ± 5.93 years) and 20 controls (mean age: 26 ± 5.83 years) were included for analysis. Higher ADC (p < 0.001) and FA (p < 0.001) was observed in NOA testes compared to controls. Differences in FA were found between groups 1 and 3 (0.07 vs 0.10, p = 0.26) and groups 2 and 3 (0.07 vs 0.10, p = 0.03), but not between groups 1 and 2 (p = 0.66). An increase in FA was observed in NOA testes with Sertoli cell-only syndrome compared to hypospermatogenesis and maturation arrest. FA was higher in NOA testes with negative results for the presence of sperm compared to those with positive results (0.09 vs 0.07, p = 0.006). FT showed "abnormal" fiber tracts in NOA testes (p < 0.001).
3.0 T DTI and FT provide an insight into deranged spermatogenesis in NOA testes.
评估 3.0T 弥散张量成像（DTI）和纤维束示踪（FT）在非梗阻性无精子症（NOA）检查中的作用。
本前瞻性研究纳入了连续的 NOA 男性和对照组。进行了 3.0T 阴囊 MRI 检查，包括 DTI。计算睾丸表观弥散系数（ADC）和各向异性分数（FA）。创建 FT 重建。采用 Kruskal-Wallis 检验，然后进行两两比较，评估 NOA 组织学表型（第 1 组：生精功能低下；第 2 组：成熟阻滞；第 3 组：唯支持细胞综合征）与正常睾丸之间睾丸 ADC 和 FA 的差异。采用 Mann-Whitney-U 检验比较精子获取呈阳性和阴性的 NOA 睾丸的 ADC 和 FA。对睾丸纤维束进行视觉评估。纤维束数量较少、厚度减小、中断和/或紊乱被认为是“异常”。卡方检验和二元逻辑回归分析评估睾丸纤维束形态的变化。
29 名 NOA 男性（平均年龄：39±5.93 岁）和 20 名对照组（平均年龄：26±5.83 岁）纳入分析。与对照组相比，NOA 睾丸的 ADC（p<0.001）和 FA（p<0.001）更高。第 1 组和第 3 组（0.07 与 0.10，p=0.26）以及第 2 组和第 3 组（0.07 与 0.10，p=0.03）之间的 FA 存在差异，但第 1 组和第 2 组之间无差异（p=0.66）。与生精功能低下和成熟阻滞相比，唯支持细胞综合征的 NOA 睾丸中 FA 增加。与精子存在呈阳性结果相比，精子不存在呈阴性结果的 NOA 睾丸中 FA 更高（0.09 与 0.07，p=0.006）。FT 显示 NOA 睾丸中的纤维束“异常”（p<0.001）。
3.0T DTI 和 FT 提供了对 NOA 睾丸中精子发生紊乱的深入了解。
