MRI fingerprints in testes of infertile men with clinical varicocoele: A narrative review.

IF 3.2 2区 医学 Q1 ANDROLOGY
Andrology Pub Date : 2025-03-22 DOI:10.1111/andr.70028
Athina C Tsili, Vassiliki Pasoglou, Olga Xiropotamou, Nikolaos Sofikitis, Maria I Argyropoulou
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引用次数: 0

Abstract

Background: Varicocoele represents the most common cause of male infertility, although most men with varicocoele remain fertile. Currently, no specific or sufficiently reliable criteria exist to identify patients who would benefit from varicocoele treatment to prevent impaired spermatogenesis. Emerging evidence suggests that magnetic resonance imaging (MRI) may provide valuable noninvasive insights into the mechanisms of testicular parenchymal damage in infertile men with clinical varicocoele.

Objectives: The aim of this narrative review was to discuss the applications of advanced MRI techniques, including diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), dynamic contrast-enhanced MRI (DCE-MRI), and proton magnetic resonance spectroscopy (1H-MRS) in the assessment of testes in infertile men with clinical varicocoele and their role in uncovering the complex mechanisms impairing fertility.

Materials and methods: PubMed database was searched for original articles published during 2010-2024.

Results: Advanced MRI techniques reveal alterations in apparent diffusion coefficient (ADC), fractional anisotropy (FA), intratesticular vasculature, and testicular metabolites in men with varicocoele compared to healthy controls. Decrease in testicular ADC and FA is detected in men with varicocoele, indicating microstructural abnormalities. Testes with varicocoele enhance fast and strongly during the early phases of dynamic imaging, providing a valuable insight into tissue perfusion. Proton MR spectra of infertile testes with varicocoele show a decrease in concentrations of choline, myoinositol, Glx complex, and lipids, signifying metabolic signatures of deranged spermatogenesis.

Conclusions: Preliminary findings from advanced MRI techniques, including DWI, DTI, DCE-MRI, and 1H-MRS have demonstrated potential as noninvasive biomarkers of impaired spermatogenesis, by evaluating testicular microstructure, perfusion, and biochemical milieu.

背景:精索静脉曲张是男性不育的最常见原因,尽管大多数患有精索静脉曲张的男性仍然具有生育能力。目前,还没有特定的或足够可靠的标准来确定哪些患者可以从精索静脉曲张治疗中获益,以防止精子发生受损。越来越多的证据表明,磁共振成像(MRI)可能为临床精索静脉曲张的不育男性睾丸实质损伤的机制提供有价值的非侵入性见解。目的:本文的目的是讨论先进的MRI技术,包括弥散加权成像(DWI)、弥散张量成像(DTI)、动态对比增强MRI (DCE-MRI)和质子磁共振波谱(1H-MRS)在临床精索静脉曲张不育男性睾丸评估中的应用,以及它们在揭示影响生育能力的复杂机制中的作用。材料与方法:检索PubMed数据库2010-2024年间发表的原创文章。结果:先进的MRI技术显示,与健康对照相比,精索静脉曲张男性的表观扩散系数(ADC)、分数各向异性(FA)、睾丸内血管和睾丸代谢物发生了变化。精索静脉曲张患者睾丸ADC和FA降低,提示显微结构异常。在动态成像的早期阶段,精索静脉曲张的睾丸增强迅速而强烈,为组织灌注提供了有价值的见解。伴有精索静脉曲张的不育睾丸的质子磁共振光谱显示胆碱、肌醇、Glx复合物和脂质的浓度降低,表明精子发生紊乱的代谢特征。结论:通过评估睾丸微观结构、灌注和生化环境,包括DWI、DTI、DCE-MRI和1H-MRS在内的先进MRI技术的初步发现已经证明了作为精子发生受损的非侵入性生物标志物的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Andrology
Andrology ANDROLOGY-
CiteScore
9.10
自引率
6.70%
发文量
200
期刊介绍: Andrology is the study of the male reproductive system and other male gender related health issues. Andrology deals with basic and clinical aspects of the male reproductive system (gonads, endocrine and accessory organs) in all species, including the diagnosis and treatment of medical problems associated with sexual development, infertility, sexual dysfunction, sex hormone action and other urological problems. In medicine, Andrology as a specialty is a recent development, as it had previously been considered a subspecialty of urology or endocrinology
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