Diffusion‐weighted magnetic resonance imaging in the detection of testicular torsion: Feasibility study

Abstract

Purpose: To investigate the feasibility and usefulness of diffusion-weighted magnetic resonance imaging in the detection of testicular torsion. Materials and Methods:Institutional Review Board approval and informed consent from all participants were obtained. Consecutive 28 patients with acute scrotal symptoms were included in this study. Fat-suppressed T2-weighted, dynamic subtraction contrast-enhanced, and diffusion-weighted images were obtained in the coronal plane with a 1.5 T MR unit. An apparent diffusion coefficient (ADC) map was reconstructed from the diffusion-weighted images obtained with b-factor of 0 and 800 s/mm 2 . Comparisons of ADC values between the affected and nonaffected testes were performed with Mann-Whitney's U-test.Results: Diffusion-weighted and ADC images with diagnostic quality were obtained in 23 out of the 28 patients (82%). In testicular torsion (n ¼ 9), the mean ADC value of the twisted testes was significantly lower than that of the nonaffected testes (0.750 6 0.297 vs. 1.017 6 0.165 Â 10 À3 mm 2 /sec, P < 0.05). In other scrotal disorders (n ¼ 14), there was no significant difference in the mean ADC value of the testes between the affected and nonaffected side (P ¼ 0.655). The affected-to-nonaffected ratio of ADC value was significantly lower in testicular torsion than that in other scrotal disorders (P < 0.05).Conclusion: Diffusion-weighted imaging of the scrotum with testicular ADC measurement can allow for the detection of testicular torsion without any use of contrast media.

Comparison of diffusion-weighed MRI findings of the testis in patients with the advanced stage unilateral testicular varicocele

“…Kangasniemi et al [15] has detected an 18 % and 20 % reduction in the ADC values obtained from mice testicles compared to the control group in 1 st and 2 nd hours respectively . Maki et al [5] have observed a reduction in the ADC values of patients with testis torsion and obtained an 82% accuracy with DWI. Gulum et al [16] have reported reduced ADC values due to the ischemia and the fibrosis in patients with hydrocele.…”

“…However, with the recent advances in functional magnetic resonance imaging (MRI) techniques, varicocele and testicular parenchymal tissue may be evaluated as well [4][5][6]. Diffusion-weighted imaging (DWI) is a functional MRI technique, and is the measurement of the decrease and increase of microscopic water movements within the tissue A reduction of movement of water molecules in tissue is defined as the diffusion restriction [7,8].…”

Role of diffusion weighted magnetic resonance imaging in a rat model of testicular torsion

“…We were unable to identify a clear threshold value owing to the small number of subjects. Tsili et al 24 examined 147 healthy testicles with DWI and they stated that reference mean ADC values of testicles were between 1.08 3 10 Maki et al 25 showed that DWI of the testicles with ADC measurement can allow for the detection of TT in patients without any use of contrast media. They used b-factors of 0 and 800 s mm 22 , as in our study.…”

Role of MR Spectroscopy (H1-MRS) of the Testis in Men with Semen Analysis Altered

“…Magnetic Resonance (MR) of the testis, by means of classic T1 and T2 weighted sequences, is the second level choice to study the parenchymal pattern, the vascularization and for the morphovolumetric characterization [9][10][11][12][13][14].…”