Findings of fat‐suppressed T2‐weighted and diffusion‐weighted magnetic resonance imaging in the diagnosis of non‐palpable testes

• Published in: BJU international Vol. 107; no. 2; pp. 290 - 294
• Main Authors: Kato, Toshiki, Kojima, Yoshiyuki, Kamisawa, Hideyuki, Takeuchi, Mitsuru, Mizuno, Kentaro, Sasaki, Shigeru, Kohri, Kenjiro, Hayashi, Yutaro
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2011; Wiley-Blackwell
• Subjects: Adipose Tissue; Biological and medical sciences; Child; Child, Preschool; cryptorchidism; Cryptorchidism - diagnosis; diagnostic imaging; diffusion MRI; Epidemiologic Methods; Genital system. Mammary gland; Humans; Image Interpretation, Computer-Assisted - methods; Infant; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging - methods; Male; Medical sciences; MRI; Nephrology. Urinary tract diseases; Radiodiagnosis. Nmr imagery. Nmr spectrometry; vanishing testis; Human; Nephrology; MRI; Cryptorchidism; vanishing testis; Congenital disease; Nuclear magnetic resonance imaging; Urology; diagnostic imaging; Accuracy; Malformation; diffusion MRI; Medical imagery; Diagnosis; Male genital diseases; Testicular diseases
• ISSN: 1464-4096; 1464-410X; 1464-410X
• DOI: 10.1111/j.1464-410X.2010.09513.x

Study Type – Diagnostic (exploratory cohort)
Level of Evidence 2b What’s known on the subject? and What does the study add? Both conventional magnetic resonance imaging (MRI) and ultrasonography (US) have been used for children with non‐palpable testes to facilitate a preoperative diagnosis, but the accuracy of these examinations was not satisfactory. In the present study, to improve the diagnostic accuracy of non‐palpable testes by MRI examination, we employed fat‐suppressed T2‐weighted imaging and DWI, as well as conventional MRI. Additional MRI assessments are useful methods to improve the accuracy of diagnosing non‐palpable testes. OBJECTIVE To evaluate the magnetic resonance imaging (MRI) findings, diagnostic accuracy and clinical usefulness of fat‐suppressed T2‐weighted and diffusion‐weighted imaging (DWI) in the management of non‐palpable testes. PATIENTS AND METHODS In all, 56 children (63 non‐palpable testes) aged 8 months–11 years (mean 24.7 months) with non‐palpable testes were enrolled. T1‐ and T2‐weighted imaging, as well as fat‐suppressed T2‐weighted imaging and DWI were performed during MRI examination, and the imaging results were compared with surgical findings. RESULTS In the 63 non‐palpable testes, MRI identified 22% (14/63) as intra‐abdominal, 20% (13/63) as intra‐canalicular, 29% (18/63) as testicular nubbins, and 29% (18/63) as unidentifiable. Although it was difficult to confirm their presence in the abdominal cavity using T1‐ and T2‐weighted imaging alone, additional assessment, including fat‐suppressed T2‐weighted imaging and DWI facilitated the detection of intra‐abdominal testes more easily because they were imaged at a markedly higher signal intensity. The sensitivity, specificity and positive and negative predictive values for the MRI vs the operative findings were 100, 97.3, 96.3, and 100%, respectively. The overall prediction accuracy was 98.4%. CONCLUSION Additional MRI assessments, fat‐suppressed T2‐weighted imaging and DWI are useful examinations to improve the preoperative diagnostic accuracy of non‐palpable testes.