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Correlation Between Semen Analysis Parameters and Diffusion-Weighted Magnetic Resonance Imaging of the Testicles in Patients With Varicocele

A Pilot Study

Çekiç, Bülent, MD*; Kiliç, Koray Kaya, MD*; Toslak, Iclal Erdem, MD*†; Şükun, Abdullah, MD*; Sağlik, Semih, MD; Savaş, Murat, MD§; Köroğlu, Mert, MD

Journal of Computer Assisted Tomography: May/June 2018 - Volume 42 - Issue 3 - p 423–428
doi: 10.1097/RCT.0000000000000693
Abdominal Imaging

Purpose The aims of this study were to evaluate using testicle apparent diffusion coefficient (ADC) values in patients with varicocele and compare them with those of healthy individuals, to identify an optimal ADC threshold level to predict abnormal semen analysis using diffusion-weighted imaging.

Materials and Methods Thirty-one patients with the diagnosis of varicocele and 20 healthy controls were enrolled in the study. All subjects underwent testicle diffusion-weighted imaging at b values of 0, 400, and 800 s/mm2 and semen analysis. Student t tests were used to compare continuous variables between 2 groups. Testicle ADC values were correlated with semen analysis parameters. The relationship between ADC values and impaired semen analysis parameters was evaluated using Pearson correlation coefficient analysis. Receiver operating characteristic curves were formed. Cut-off values for ADC, sensitivity, and specificity values were measured.

Results There was a negative correlation between mean ADC values and plexus pampiniformis vein diameter (r = −0.467, P < 0.001) and a positive correlation between mean ADC values and sperm count (r = 0.838, P < 0.001) as well as sperm morphology (r = 0.548, P < 0.05). Sensitivity values of 94.3% and 86.6% and specificity values of 87.5% and 43.8% were determined for the best cut-off ADC values in diagnosing the sperm count and morphology, respectively (area under the curve, 0.961 and 0.781).

Conclusions Decreased testicular ADC values in patients with varicocele are significantly correlated with semen parameters. This method may be used to determine the degree of testicular parenchymal destruction. In addition, testicular ADC cut-off values might be useful in dyspermia patients for the management of patients with varicocele.

From the *Department of Radiology, Antalya Training and Research Hospital, Antalya, Turkey;

Department of Radiology, Loyola University Medical Center Maywood, IL;

Department of Radiology, Siirt State Hospital, Siirt;

§Department of Urology, Antalya Training and Research Hospital, Antalya; and

Department of Radiology, Şişli Memorial Hospital, Istanbul, Turkey.

Received for publication July 2, 2017; accepted September 11, 2017.

Correspondence to: Bülent Çekiç, MD, Department of Radiology, Antalya Training and Research Hospital, 07100, Antalya, Turkey (e-mail:

The authors declare no conflicts of interest.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Declaration of Helsinki 1964 and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants of this study.

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