MRI in the Histologic Characterization of Testicular Neoplasms

Tsili, Athina C.; Tsampoulas, C.; Giannakopoulos, X; Stefanou, Dimitrios; Alamanos, Yiannis; Sofikitis, Nikolaos; Efremidis, Stavros C.

doi:10.2214/ajr.07.2267

Cited by 83 publications

(72 citation statements)

References 31 publications

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“…[4][5][6][7] The MR criteria used to characterize testicular neoplasms were similar to those presented in the literature, including the presence of a mainly hypointense or a heterogeneous mass lesion on T2-weighted images, inhomogeneously enhancing after contrast material administration. [4][5][6][7]26,27 The coexistence of areas of hemorrhage or necrosis, invasion of testicular tunicae, and extension of the tumor to the paratesticular space and/or the spermatic cord confirmed the diagnosis of malignancy, as it was subsequently proved on histopathology. Although the same group of authors reported the absence of contrast material enhancement as the most sensitive sign in predicting the benign nature of an intratesticular lesion, this study had two false positives, detected as heterogeneously enhancing masses.…”

Section: Discussionmentioning

confidence: 94%

“…Intratesticular malignancies were diagnosed using the MR criteria known from previously published reports. 7,26,27 Testicular carcinomas were detected as either of low (n59) or heterogeneous (n55) signal intensity on T2-weighted images, with areas of hemorrhage (n55) or necrosis (n55), all heterogeneously enhancing after contrast material administration (Figures 2 Diffusion-weighted MR imaging of scrotal diseases AC Tsili et al 650 and 3). There was also invasion of the testicular tunicae by the neoplasm in two cases, invasion of the epididymis in one case and extension of the tumor to the spermatic cord in three patients ( Figure 2).…”

Section: Resultsmentioning

confidence: 99%

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Diffusion-weighted MR imaging of normal and abnormal scrotum: preliminary results

Tsili¹,

Argyropoulou²,

Giannakis³

et al. 2012

Asian J Androl

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Magnetic resonance (MR) imaging of the scrotum represents an important supplemental diagnostic tool in the evaluation of scrotal diseases. Diffusion-weighted (DW) MR imaging is a developing technique, proved to improve tissue characterization. We evaluated the feasibility and diagnostic performance of DW MR imaging in the detection and characterization of scrotal lesions. We retrospectively evaluated 31 scrotal lesions (23 intratesticular and 8 extratesticular) in 26 men. All MR examinations were performed on a 1.5-T unit, using a pelvic-phased array coil. DW sequences were obtained using a single shot, multislice spin echo planar diffusion pulse sequence and a b factor of 0 and 900 s mm 22 . The DW MR characteristics and the apparent diffusion coefficient (ADC) values of normal scrotal contents and scrotal diseases were evaluated. Comparison between the ADC values of normal scrotum, benign lesions and scrotal malignancies was performed. The accuracy of conventional sequences, DW images alone and DW imaging combined with conventional images in differentiating benign from malignant scrotal lesions was calculated. The ADC values of testicular malignancies were different from those of normal testis and benign intratesticular lesions, and the ADC values of benign extratesticular lesions from those of normal epididymis (P,0.05). The overall accuracy of conventional imaging, DW imaging alone and DW MR combined with conventional sequences in the characterization of intratesticular lesions was 91%, 87% and 100%, respectively. Our findings suggest that DW MR imaging and ADC values may provide valuable information in the diagnosis and characterization of scrotal diseases.

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Section: Discussionmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Diffusion-weighted MR imaging of normal and abnormal scrotum: preliminary results

Tsili¹,

Argyropoulou²,

Giannakis³

et al. 2012

Asian J Androl

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“…Scrotal MR imaging facilitates differentiation between benign and malignant lesions with high accuracy (3). On the basis of recent data, investigators have suggested that MR imaging findings could be closely correlated with the histologic characteristics of testicular neoplasms, providing a preoperative classification of the histologic type of testicular tumors (4). MR imaging is also highly accurate in the differentiation of extratesticular from intratesticular disease (5).…”

Section: Introductionmentioning

confidence: 99%

MR Imaging of Scrotal Tumors and Pseudotumors

Cassidy¹,

Ishioka²,

McMahon³

et al. 2010

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Magnetic resonance (MR) imaging is an important imaging technique in the evaluation of scrotal masses, providing a useful adjunct to ultrasonography (US). Although US is the modality of choice for initial evaluation of scrotal pathologic conditions because of its wide availability, low cost, and high sensitivity for detection of testicular and paratesticular disease processes, US findings may occasionally be inconclusive. MR imaging may provide additional information in these cases, often affecting patient management. This article reviews and illustrates the MR imaging features of solid extratesticular and intratesticular benign and malignant scrotal tumors, as well as nonneoplastic lesions that can mimic neoplasia. Normal scrotal MR anatomic features and optimal MR imaging technique are also presented.

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“…1,6 When US gives confusing information due to altering echogenicity, MRI could play a complementary role in such cases. 11,12 In our case MRI was the most useful tool for differentiating the scrotal structures clearly so providing an anatomical road map for surgery. Although seminal vesicle attachment could not be exhibited exactly but intrapelvic extension has been demonstrated.…”

Section: Discussionmentioning

confidence: 65%

A unique scrotal extratesticular epidermod cyst attached to the seminal vesicles

Sağlam

Kumsar

Köse

et al. 2013

CUAJ

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E244 research researchCite as: Can Urol Assoc J 2013;7:E244-7. http://dx.doi.org/10.5489/cuaj.546 AbstractA 46-year-old man was admitted with a scrotal long standing painless mass. The workup included physical examination, alpha-fetoprotein (αFP) and beta-human chorionic gonadotropin (β-hCG) analyses, scrotal ultrasound, magnetic resonance imaging and urethrocystoscopy. Surgical exploration revealed a separate mass between the testes extending superiorly with a thin stalk. It was dissected easily to the anterior aspect of the seminal vesicles and removed from the junction to the seminal vesicles. Pathology reported an epidermoid cyst. To our knowledge this is the first case of a scrotal extratesticular epidermoid cyst attached to the seminal vesicles.

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MRI in the Histologic Characterization of Testicular Neoplasms

Abstract: Our study shows that MRI provides a credible preoperative differentiation of seminomatous from nonseminomatous testicular tumors, with excellent interobserver agreement.

Cited by 83 publications

References 31 publications

Diffusion-weighted MR imaging of normal and abnormal scrotum: preliminary results

Diffusion-weighted MR imaging of normal and abnormal scrotum: preliminary results

MR Imaging of Scrotal Tumors and Pseudotumors

A unique scrotal extratesticular epidermod cyst attached to the seminal vesicles

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