A rupture of corpus cavernosum (CC) is a rare injury of the erect penis. The present study describes the role of MRI for diagnosis and follow-up of this injury. Four patients with clinically suspected acute penile fractures underwent MRI. Imaging findings were confirmed at surgery. In three patients, follow-up MRI was also available at 1, 6 and 16 weeks after surgical repair. In all patients pre-contrast T1-weighted images (T1WI) clearly disclosed ruptures of CC, which depicted as discontinuity of low signal intensity of the tunica albuginea (TA). Concomitant subcutaneous haematoma were well visualised both on T1-weighted (T1WI) and T2-weighted images, whereas haematoma in CC were optimally demonstrated on contrast-enhanced T1WI. On follow-up MRI all fractures presented similar healing process. Shortly after the repair, the tunical suture showed an increase in signal intensity on pre-contrast T1WI and was strongly enhanced with the administration of contrast material. Then the tear site gradually recovered low signal intensity on all spin-echo sequences by 4 months after surgery. These serial findings may suggest the formation of vascularised granulation tissue during cicatrisation. Magnetic resonance imaging is of great value for the diagnosis and follow-up in patients with penile fracture.
Congenital seminal vesicle cysts associated with ipsilateral renal agenesis or dysplasia are rare malformations. Even though they are more often diagnosed today due to the introduction of advanced, sectional imaging techniques as CT and MRI, no reliable data about the prevalence of this malformation are available. This study reports seven consecutive cases, with long-term follow-up in five cases (26-119 months, mean 52 months). All patients underwent sonography, excretory urography, CT and MRI. Only two of seven patients presented nonspecific symptoms of the lower urinary tract; five were asymptomatic. In all cases sonography revealed the cystic character of the retrovesical enlargement. The anatomy of the lower pelvis was most accurately shown on MRI, which depicted the ectopic insertion of the ureter into the seminal vesicle in five cases. Cysts demonstrated high signal intensities in T1- and T2-weighted spin-echo images. In five cases the CT density was over 40 HU. Whereas one patient (15 years) presented significant enlargement of the cysts 10 years after primary diagnosis with compression of the urinary bladder, four patients showed no changes of their malformation in the follow-up examinations. The present data therefore support the concept of treating only symptomatic patients.
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