Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters

Abstract

Objective: The aim of the present study was to investigate the diagnostic value of strain elastography (SE) of testicular tissues in infertile population. We also evaluated the correlation between SE results with semen parameters and hormone profiles of the patients. Material and methods:A total of 61 patients and 122 testes were evaluated. Patients who were evaluated in an andrology outpatient clinic with the diagnosis of infertility and referred to radiology department for investigation of reproductive organs between June 2015 and January 2016 were included. Patients were divided into two groups according to semen analyses results as normal (Group 1) and abnormal (Group 2). Hormone profiles, semen analyses, B-mode, coloured Doppler ultrasonography and sonoelastography examinations were performed for each patient. Measurements of testicular volumes, resistive indices (RI) in intraparenchymal arteries, strain, strain ratio (SR) and presence of varicocele were recorded.Results: Mean age of participants was 33.7±6.3 years. Mean testicular volumes (Group 1, 19.41±4.8 mL, and Group 2, 17.64±3.62 mL) were significantly different between groups (p= 0.023). Mean SRs were also different between Groups 1 and 2 (0.12±0.08 vs. 0.22±0.18, p<0.001). Testicular volumes were directly proportional with SRs in Group 1. Strain values had inverse relationship with sperm concentration and total motile sperm counts in Group 2 (p= 0.01). SRs were found to be positively correlated with RI and sperm morphology in Group 2 (p<0.05). Although FSH values showed significant difference among groups, any correlation between FSH and elastographic parameters could not be displayed. Conclusion:Strain elastography results were found to be significantly different in patients with abnormal sperm counts. This technique may provide promising results, however, further large scale studies may help to clarify the value of this imaging modality in the assessment of male infertility.

Testicular stiffness in varicocele: evaluation with shear wave elastography

“…All grayscale and SWE examinations were performed using an Aplio 500 Platinum (Canon, Tokyo, Japan) US unit. The measurements were conducted using a linear array high-frequency transducer (11)(12)(13)(14). The testicular volumes were calculated from 2-dimensional images using the prolate ellipsoid method based on the formula: volume=length×width× height×0.523.…”

Effects of varicocele on testicles: Value of strain elastography: A prospective controlled study

“…Pinggera et al found that the RI measurement of the intratesticular arteries showed an increased testicular vascular resistance in patients with pathological sperm characteristics in comparison to the control group (Pinggera et al, ). However, in a different study, no difference was observed (Kucukdurmaz et al, ). In our study, the median RI value was found to be higher in the patients with varicocele and bad seminal parameters than in the patients in the control group.…”

“…Kucukdurmaz et al compared two groups with normal and abnormal sperm parameters using elastography; they found that the SR ratio was significantly lower in the group with abnormal seminal parameters. They also found that the average testicular volume was lower in the group with abnormal seminal parameters (Kucukdurmaz et al, ). In a study in which (Dede et al ( compared the elastography images of patients with varicocele and without varicocele, the SR value of the varicocele group was lower.…”

“…In another study, no relation was found between varicocele and testicular elasticity. Furthermore, no correlation between the FSH level and the elastography findings was observed (Kucukdurmaz et al, ). In our study, the hormone profiles for both groups showed an increase in the LH level in the varicocele group, and a significant difference was found between the FSH and testosterone levels.…”

“…With SWE, a short (0.03–0.4), high power (frequency 2.67 MHz) acoustical propellant radiation force is applied to the tissue with US probes instead of using external compression. Some studies have evaluated the elasticity of testicular tissue using elastography US (Dede et al, ; Kucukdurmaz et al, ).…”