[Differentiation of testicular diseases using dynamic MRT].
Sonography and colour-coded Doppler sonography are the methods of first choice in diagnosing tumors of the testes. The present study aimed at resolving whether dynamic MRT can improve diagnostic relevance in diseases of the testes compared with conventional spin echo images. The testes of 20 healthy volunteers and of 16 patients of the Department of Urology of the University of Bonn were examined by means of MR tomography. Within 12 hours after MR tomography the patients were surgically explored, biopsied and if necessary orchiectomised. Results obtained with the volunteers were uniform and well reproducible, independent of external influences. On comparing the maximal enhancement curves of the examined various testicular tumors with the standard values established by examining the healthy volunteers, the curves obtained with the malignant testicular tumors were always clearly above the chosen confidence range of 3 standard deviations so that malignancy diagnosis was easy. However, the degree of maximal enhancement did not enable us to arrive at a conclusion in respect of the tumor type or the degree of malignancy. The greatest enhancement occurred with the tumor of Sertoli's cell which could thus be clearly differentiated against the other malignant testicular tumors. Due to masking of the gadolinium effect by haemosiderin deposits, haemorrhagica in the tumor tissue should be excluded by means of T2-weighted spin echo sequences before following up a suspicion of malignant testicular tumor. Benign intratesticular changes could be safely separated from malignant findings by means of the maximal enhancement curve lying in the normal range or below the curve of the volunteers. As with other organs, dynamic MR tomography yields definitely more and better information than conventional MR tomography also in the diagnosis of testicular tumours. However, these "pros" do not offset the "cons" of high costs of such examinations, so that both conventional sonography and angiodynography remain the routine methods of choice. Indication for MR examination on suspicion of testicular tumour is therefore confined to cases where sonographic findings are clinically equivocal or technically unsatisfactory.
Kaiser
W A
WA
Reinges
M H
MH
Miersch
W D
WD
Vogel
J
J
D000328:Adult; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013733:Testicular Diseases / Q000175:diagnosis*; D013736:Testicular Neoplasms / Q000175:diagnosis*
Differenzierung von Hodenerkrankungen mit der dynamischen MRT.