title: Diffusion-weighted magnetic resonance imaging in the detection of testicular torsion: feasibility study.
abstract: OBJECTIVE
  To investigate the feasibility and usefulness of diffusion-weighted magnetic resonance imaging in the detection of testicular torsion.
  
  
  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 = 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) mm(2)/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).
  
  
  CONCLUSIONS
  Diffusion-weighted imaging of the scrotum with testicular ADC measurement can allow for the detection of testicular torsion without any use of contrast media.
authors.affiliation: Department of Radiology, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Maki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Masako
authors.initials: M
authors.lastname: Nagayama
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ishimori
authors.forename: Akira
authors.initials: A
authors.lastname: Okumura
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Amoh
authors.forename: Satoru
authors.initials: S
authors.lastname: Nakashita
authors.forename: Akihito
authors.initials: A
authors.lastname: Terai
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Dodo
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D004058:Diffusion; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012611:Scrotum / Q000473:pathology; D013086:Spermatic Cord Torsion / Q000175:diagnosis* / Q000473:pathology*; D013737:Testis / Q000473:pathology
chemical_list: D003287:Contrast Media