{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:41:04Z","timestamp":1788349264582,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Azoospermia affects about 15% of childless males. The differential diagnosis between subtypes of azoospermia is the initial step in its management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the role of diffusion\u2010weighted magnetic resonance imaging and proton magnetic resonance spectroscopy in distinguishing obstructive azoospermia from non\u2010obstructive azoospermia and predicting sperm retrieval together with histological alterations in men with non\u2010obstructive azoospermia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This prospective comparative study involved 60 men with obstructive azoospermia (group A) and 60 men with non\u2010obstructive azoospermia (group B). Scrotal proton magnetic resonance spectroscopy and diffusion\u2010weighted magnetic resonance imaging were conducted for all participants to respectively evaluate testicular metabolites and normalized apparent diffusion coefficient 1 week before sperm retrieval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Apparent diffusion coefficient was significantly higher in group B as compared to group A (0.47\u00a0\u00b1\u00a00.11\u00a0vs. 0.29\u00a0\u00b1\u00a00.05; and 0.46\u00a0\u00b1\u00a00.14\u00a0vs. 0.28\u00a0\u00b1\u00a00.02) for the right and left testis, respectively. Conversely, testicular choline and lipids were significantly higher in group A as compared to group B. Normalized apparent diffusion coefficient, choline, and lipids at cut\u2010off levels of 0.353, 0.31, and 0.725 could differentiate between obstructive azoospermia and non\u2010obstructive azoospermia (area under the curve\u00a0=\u00a00.963; confidence interval\u00a0=\u00a00.939\u20130.986, area under the curve\u00a0=\u00a00.985; confidence interval\u00a0=\u00a00.974\u20130.997, and area under the curve\u00a0=\u00a00.970; confidence interval\u00a0=\u00a00.940\u20130.999, respectively). Regarding the prediction of sperm retrieval in the non\u2010obstructive azoospermia group, choline levels had the highest area under the curve (0.923), and its cut\u2010off level was 0.195. The normalized apparent diffusion coefficient was significantly lower in men with positive sperm retrieval as compared to men with unsuccessful retrieval. Finally, it was revealed that all magnetic resonance imaging parameters except creatine could independently predict testicular histology in men with non\u2010obstructive azoospermia. The highest prediction was 95% in normal spermatogenesis, and the least prediction was 40% in spermatid arrest. Regression analysis was used to detect final predictors and extrapolate an equation that could be used to predict testicular pathology<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Normalized apparent diffusion coefficient and proton magnetic resonance spectroscopy are helpful in differentiating obstructive azoospermia from non\u2010obstructive azoospermia and predicting sperm retrieval and related histological alterations in men with non\u2010obstructive azoospermia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.13392","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T22:25:29Z","timestamp":1674512729000},"page":"1096-1106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Diffusion\u2010weighted magnetic resonance imaging and magnetic resonance spectroscopy for non\u2010invasive characterization of azoospermia: A prospective comparative single\u2010center study"],"prefix":"10.1111","volume":"11","author":[{"given":"Ahmed","family":"Hesham Said","sequence":"first","affiliation":[{"name":"Department of Radiology Faculty of Medicine, Beni\u2010Suef University  Beni\u2010Suef Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7875-0352","authenticated-orcid":false,"given":"Ahmed","family":"Ragab","sequence":"additional","affiliation":[{"name":"Department of Andrology Sexology, and STDs Faculty of Medicine, Beni\u2010Suef University  Beni\u2010Suef Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"Zohdy","sequence":"additional","affiliation":[{"name":"Department of Andrology Sexology, and STDs Faculty of Medicine, Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Sayed","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Radiology El Wasta general hospital  Beni\u2010Suef Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Sayed","family":"Abd El Basset","sequence":"additional","affiliation":[{"name":"Department of Radiology Faculty of Medicine, Beni\u2010Suef University  Beni\u2010Suef 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