Diffusion-Weighted and Magnetization Transfer Imaging in Testicular Spermatogenic Function Evaluation: Preliminary Results

Purpose: To assess the use of functional magnetic resonance imaging (MRI), including diffusion-weighted MRI (DWI) and magnetization transfer MRI (MTI) in evaluating male infertility. Materials and Methods: Sixteen men with testicular spermatogenesis hypofunction confirmed by percutaneous testis biopsy and 31 volunteers (control group B, age range: 20–40 years) with normal semen analysis including younger (By, n = 15, age range: 20–30 years) and older (Bo, n = 16, age range: 31–40 years) men underwent pelvic 3T MRI, including DWI and MTI. Apparent diffusion coefficient (ADC) and magnetization transfer ratio (MTR) were compared. Results: The ADCs in 32 testes of 16 patients (0.497 ± 0.037 × 10^-3 mm²/s) were significantly (P < 0.001) higher than that of control group B (0.460 ± 0.031 × 10^-3 mm²/s), group By (0.453 ± 0.018 × 10^-3 mm²/s), and group Bo (0.461 ± 0.034 × 10^-3 mm²/s), whereas the MTRs were significantly lower than that of group B (16.14 ± 4.20), group By (17.88 ± 2.00), and group Bo (15.09 ± 4.28) (P < 0.001). Conclusion: Functional MRI, including DWI and MTI, appears promising for evaluating male infertility with higher ADC and lower MTR in testicular spermatogenesis hypofunction. Level of Evidence: 2. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2018;47:186–190.