MR弥散加权成像对无精子症患者睾丸无创性诊断的价值  

The value of diffusion-weighted imaging in noninvasive diagnosis of azoospermic testes

作　　者：张进华 蔡威 ZHANG Jinhua;CAI Wei(Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)

机构地区：[1]华中科技大学、同济医学院、附属同济医院放射科,湖北武汉430030

出　　处：《暨南大学学报（自然科学与医学版）》2023年第5期506-512,共7页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：国家重点研发计划基金项目(2022YFC2702700)。

摘　　要：目的:探讨核磁共振(MR)弥散加权成像(DWI)对无精子症诊断的应用价值。方法:前瞻性分析146例无精子症患者的MR影像资料,其中61例梗阻性无精症患者,85例非梗阻性无精症患者,术前1个月进行DWI扫描,测量两组患者睾丸不同扩散敏感因子(b值)的表观扩散系数(ADC)值(ADC_(50-0),ADC_(100-0),ADC_(500-0),ADC_(1000-0),ADC_(1500-0),ADC_(2000-0),ADC_(2500-0),ADC_(3000-0)),并进行对比分析。结果:非梗阻性无精症患者在不同b值的DWI图像下的ADC值均显著高于梗阻性无精症患者(P<0.001),且在各个b值下的ADC值ROC分析结果AUC均大于0.7,且P<0.001,说明其诊断效能较高。ADC_(3000-0)的曲线下面积(AUC)显著高于其他b值下的AUC值(P<0.05)。结论:DWI序列在梗阻性无精症与非梗阻性无精症患者中ADC值差异有显著统计学意义,高b值(b值=3000)弥散加权序列可以作为无精症鉴别诊断的高效能、无创性指标。Objective:To explore the application value of diffusion-weighted magnetic resonance imaging(DWI)in the diagnosis of Azoospermia.Methods:The number of 146 patients with azoospermia were prospectively collected,including 61 patients with obstructive azoospermia and 85 patients with nonobstructive azoospermia,respectively.DWI scanning was performed one month before the surgery.DWI scans were performed to measure the apparent diffusion coefficient(ADC)values for two groups of patients at different b-values in the testicles(ADC_(50-0),ADC_(100-0),ADC_(500-0),ADC_(1000-0),ADC_(1500-0),ADC_(2000-0),ADC_(2500-0),ADC_(3000-0)).Results:The ADC values of nonobstructive azoospermia patients were significantly higher than obstructive azoospermia patients on DWI images with different b-values(P<0.001),and the receiver operating characteristic analysis results of ADC values at each b-value showed an area under the curve(AUC)greater than 0.7,with P<0.001,indicating high diagnostic efficacy.The AUC of ADC_(3000-0)was significantly higher than the AUC values across b values(P<0.05).Conclusion:There is a significant difference in ADC values between obstructive azoospermia and nonobstructive azoospermia patients using magnetic resonance diffusion weighted sequences.A high b-value diffusion-weighted sequence with a b-value of 3000 might serve as an efficient and non-invasive indicator for the differential diagnosis of azoospermia.

关 键 词：无精子症 弥散加权成像 表观扩散系数(ADC) 受试者工作特征(ROC)分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]