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Congress: ECR25
Poster Number: C-27092
Type: Poster: EPOS Radiologist (educational)
Authorblock: A. C. Tsili1, V. P. Pasoglou2; 1Ioannina/GR, 2Brussels/BE
Disclosures:
Athina C Tsili: Nothing to disclose
Vassiliki Parthena Pasoglou: Nothing to disclose
Keywords: Genital / Reproductive system male, MR, MR-Diffusion/Perfusion, MR-Spectroscopy, Diagnostic procedure, Education and training
Learning objectives Varicocele represents the most common cause of male infertility, although most men with varicocele are fertile. Currently, no specific or sufficiently reliable criteria exist to identify men who would benefit from varicocele treatment to prevent impaired spermatogenesis. This review discusses the application of advanced MRI techniques in assessing testes of infertile men with clinical varicocele.
Read more Background Preliminary observations on the use of advanced scrotal MRI techniques, including diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), dynamic contrast-enhanced (DCE) MRI, and proton magnetic resonance spectroscopy (1H-MRS) have reported promising results in the assessment of impairment of spermatogenesis in testes of infertile men with clinical varicocele, highlighting MRI as a promising research tool to enhance diagnostic precision and inform individualized treatment strategies for varicocele-associated infertility [1-7].
Read more Findings and procedure details Diffusion-Weighted ImagingIn patients with varicocele, the malfunction of valves in the internal spermatic veins can raise pressure levels up to eight times higher than normal physiological levels, leading to testicular hypoxia and oxidative stress (OS) [8]. In addition to ischemic processes, fibrotic changes may also be linked to increased pressure and fluid accumulation in testes with varicocele [9-11]. All of these changes at the microscopic level are reflected in MRI, as significant differences in testicular ADC have been observed between...
Read more Conclusion MRI, including DWI, DTI, DCE-MRI and 1H-MRS provides valuable, noninvasive fingerprints of defective spermatogenesis in testes of infertile men with clinical varicocele. Τhe ability to noninvasively identify early indicators of testicular impaired spermatogenesis based on MRI findings may have implications for the management of varicocele in the future.
Read more References Karakas E, Karakas O, Cullu N, et al. Diffusion-weighted MRI of the testes in patients with varicocele: a preliminary study AJR Am J Roentgenol 2014;202:324-328. Yıldırım Ä°O, SaÄŸlık S, Çelik H. Conventional and ZOOMit DWI for Evaluation of Testis in Patients With Ipsilateral Varicocele. AJR Am J Roentgenol 2017;208:1045-1050.  Çekiç B, Kiliç KK, Toslak IE, et al. Correlation Between Semen Analysis Parameters and Diffusion-Weighted Magnetic Resonance Imaging of the Testicles in Patients With Varicocele: A Pilot Study. J Comput Assist Tomogr 2018;42:423-428.  Emad-Eldin S, Salim AMA,...
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