酰胺质子转移加权磁共振成像评估睾丸生精功能的初步研究
Amide proton transfer-weighted magnetic resonance imaging for the evaluation of testicular spermatogenic function: a preliminary study.
作者信息
Tang Guanglei, Ma Shulin, Fu Wenhao, Yun Weijian, Peng Yang, Guan Jian
机构信息
The First Affiliated Hospital, Sun Yat-Sen University, Department of Radiology, Guangdong, China.
Linzhi People's Hospital, Department of Radiology, Tibet, China.
出版信息
Diagn Interv Radiol. 2025 Jul 8;31(4):392-398. doi: 10.4274/dir.2025.253248. Epub 2025 May 20.
PURPOSE
To determine the amide proton transfer-weighted (APTw) imaging features in testes with age, and to assess the feasibility of APTw magnetic resonance imaging (MRI) in assessing testicular spermatogenic function.
METHODS
A total of 23 male patients with clinically confirmed hypospermatogenesis caused by epididymo-orchitis were included in the case group (group A) and another 93 men (age range, 20-80 years) were included in the control group. The control group was divided into four subgroups: group B1 (20-34 years, n = 25), group B2 (35-49 years, n = 23), group B3 (50-64 years, n = 21), and group B4 (65-80 years, n = 24). All participants underwent 3.0T MRI scan, and the APT signal intensity (SI) and apparent diffusion coefficient (ADC) value of each testis were examined. The ADC and APT SI were independently measured by two radiologists blinded to clinical data, and average values were calculated. A power analysis was conducted to determine the required sample size.
RESULTS
APT SI was negatively correlated with age (r = -0.510, < 0.001), whereas ADC was positively correlated with age (r = 0.317, = 0.006). The APT SI was significantly higher in group A (1.77 ± 0.41) than in group B1 (1.43 ± 0.21), group B2 (1.37 ± 0.31), group B3 (1.30 ± 0.35), and group B4 (1.20 ± 0.35) (all < 0.01). The ADC was significantly higher in group A [(0.549 ± 0.091) × 10 mm/s] compared with group B1 [(0.449 ± 0.047) × 10 mm/s], group B2 [(0.475 ± 0.022) × 10 mm/s], and group B3 [(0.488 ± 0.051) × 10 mm/s] (all < 0.01), whereas no statistically significant difference was found between group A and group B4 ( > 0.05).
CONCLUSION
The APT SI of the normal testes decreased with age, whereas a significant elevation of APT SI was detected in patients with hypospermatogenesis caused by epididymo-orchitis.
CLINICAL SIGNIFICANCE
Hypospermatogenesis caused by degeneration or inflammation can be differentiated by APT quantity combined with ADC value.
目的
确定不同年龄睾丸的酰胺质子转移加权（APTw）成像特征，并评估APTw磁共振成像（MRI）评估睾丸生精功能的可行性。
方法
病例组（A组）纳入23例临床确诊为附睾炎所致精子发生减少的男性患者，对照组纳入另外93名男性（年龄范围20 - 80岁）。对照组分为四个亚组：B1组（20 - 34岁，n = 25）、B2组（35 - 49岁，n = 23）、B3组（50 - 64岁，n = 21）和B4组（65 - 80岁，n = 24）。所有参与者均接受3.0T MRI扫描，检测每个睾丸的APTw信号强度（SI）和表观扩散系数（ADC）值。由两名对临床数据不知情的放射科医生独立测量ADC和APTw SI，并计算平均值。进行功效分析以确定所需样本量。
结果
APTw SI与年龄呈负相关（r = -0.510，P < 0.001），而ADC与年龄呈正相关（r = 0.317，P = 0.006）。A组的APTw SI（1.77 ± 0.41）显著高于B1组（1.43 ± 0.21）、B2组（1.37 ± 0.31）、B3组（1.30 ± 0.35）和B4组（1.20 ± 0.35）（均P < 0.01）。A组的ADC[（0.549 ± 0.091）×10⁻³mm²/s]显著高于B1组[（0.449 ± 0.047）×10⁻³mm²/s]、B2组[（0.475 ± 0.022）×10⁻³mm²/s]和B3组[（0.488 ± 0.051）×10⁻³mm²/s]（均P < 0.01），而A组和B4组之间未发现统计学显著差异（P > 0.05）。
结论
正常睾丸的APTw SI随年龄降低，而附睾炎所致精子发生减少患者的APTw SI显著升高。
临床意义
退变或炎症所致精子发生减少可通过APTw量结合ADC值进行鉴别。
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