Diffusion-Weighted Magnetic Resonance Imaging in the Detection of Testicular Torsion: Feasibility Study


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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/mm2. 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 = 9), the mean ADC value of the twisted testes was significantly lower than that of the nonaffected testes (0.750 ± 0.297 vs. 1.017 ± 0.165 × 10−3 mm2/sec, P < 0.05). In other scrotal disorders (n = 14), there was no significant difference in the mean ADC value of the testes between the affected and nonaffected side (P = 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. J. Magn. Reson. Imaging 2011;. © 2011 Wiley Periodicals, Inc.

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