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(Radiology. 2000;217:219-227.)
© RSNA, 2000


Genitourinary Imaging

Scrotal Disorders: Evaluation of Testicular Enhancement Patterns at Dynamic Contrast-enhanced Subtraction MR Imaging1

Yuji Watanabe, MD, Masako Dohke, MD, Kazutoshi Ohkubo, MD, Takayoshi Ishimori, MD, Yoshiki Amoh, MD, Akira Okumura, MD, Kazushige Oda, MD, Takafumi Hayashi, MD, Yoshihiro Dodo, MD and Yoichi Arai, MD

1 From the Depts of Radiology (Y.W., M.D., T.I., Y.Amoh, A.O., K. Oda, T.H., Y.D.) and Urology (K. Ohkubo, Y.Arai), Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan. From the 1997 RSNA scientific assembly. Received Sep 2, 1999; revision requested Oct 8; revision received Dec 8; accepted January 12, 2000. Address correspondence to Y.W. (e-mail: yw5904@kchnet.or.jp).

PURPOSE: To evaluate testicular enhancement patterns in various scrotal disorders at dynamic contrast medium–enhanced subtraction magnetic resonance (MR) imaging.

MATERIALS AND METHODS: Forty-two patients with scrotal symptoms (22 testicular diseases, 20 extratesticular scrotal disorders) underwent three-dimensional (3D) fast field-echo or fast spin-echo dynamic subtraction MR imaging after injection of paramagnetic contrast medium. The relative percentages of peak height and mean slope of the testes on the affected side were compared with those on the unaffected side by using time–signal intensity curves.

RESULTS: Extratesticular scrotal disorders (time–signal intensity curve mean peak height, 93.1%; mean slope, 89.8%) showed gradual and progressive increase in homogeneous testicular contrast enhancement in all normal testes. Relative percentages of peak height and mean slope of testicular torsion (mean peak height, 17.3%; mean slope, 10.6%), infarction (mean peak height, 30.4%; mean slope, 19.8%), traumatic hemorrhagic necrosis (mean peak height, -3.5%; mean slope, -12.0%), and epidermoid cyst (mean peak height, -6.6%; mean slope, -14.2%) were significantly lower than those of extratesticular scrotal disorders. Acute mumps orchitis (mean peak height, 135.1%; mean slope, 307.5%) and malignant testicular tumor (mean peak height, 178.7%; mean slope, 467.6%) showed higher relative percentages of peak height and mean slope.

CONCLUSION: Dynamic contrast-enhanced subtraction MR imaging can provide information about testicular perfusion on the basis of contrast enhancement and can be used to differentiate testicular diseases from scrotal disorders.

Index terms: Epididymitis, 847.214 • Magnetic resonance (MR), contrast enhancement, 847.121411, 847.121415, 847.121416 • Magnetic resonance (MR), rapid imaging, 847.121416 • Magnetic resonance (MR), three-dimensional, 847.121411, 847.121415, 847.121416 • Scrotum, diseases, 847.1437, 847.214, 847.311, 969.756 • Scrotum, MR, 847.121411, 847.121415, 847.121416 • Testis, abnormalities, 847.1437, 847.1477, 847.219, 847.311, 847.91 • Testis, neoplasms, 847.30 • Testis, torsion, 847.1437 • Testis, undescended, 847.1477 • Varicocele, 969.756


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