The use of diffusion-weighted MR imaging in the functional assessment of the testes of patients with clinical varicocele.

Abstract

We aimed to evaluate the use of diffusion-weighted imaging (DWI) in the assessment of the varicocele effect on testicular parenchyma and spermatogenesis, with estimation of apparent diffusion coefficient (ADC) value changes in the testicular parenchyma. We prospectively evaluated 30 consecutive patients (18 patients with bilateral varicocele and 12 patients with unilateral varicocele) and 10 healthy controls. US and DWI were performed to all patients. A total of 80 testes were included, which divided into three groups: group A: testes ipsilateral to the varicocele (n=48, 60%); group B: testes contralateral to the varicocele (n=12, 15%); and group C: normal testes of the control (n=20, 25%). There was a statistically significant difference in mean ADC value between all groups (p-value<0.001). In groups A and B, there was a negative correlation between mean ADC values and varicocele grade as well as pampiniformis venous diameter. In group A, there was a significant positive correlation between mean ADC value and sperm count (p-value=0.01, r-value=0.48) as well as sperm motility (p-value=0.04, r-value=0.33). DWI sequence can be used to evaluate the sequel of varicocele, with decreased ADC values that are significantly correlated with abnormal semen parameters. Thus, ADC values may be considered as an ancillary indicator of testicular parenchyma changes.