title: Magnetic resonance imaging of acute scrotum.
abstract: OBJECTIVE
  The aim of the pilot study was to evaluate the feasibility of dynamic contrast enhanced (CE)-magnetic resonance imaging (MRI) in the detection of testicular ischemia and its ability to differentiate testicle torsion from other causes of acute scrotum.
  
  
  METHODS
  Seventeen boys or young men with an acute scrotum were included in the prospective study during the time period from October 2001 to December 2005. The median age of the patients was 16,4 (7-44) years. The duration of the symptoms preceding the MRI study varied from six hours to 30 days. The study protocol included physical examination by a surgeon, laboratory tests and Doppler ultrasound (DUS) and finally testicles were imaged by using a 1,5 T MRI scanner; T1-weighted and diffusion weighted images were produced. The gadolinium uptake, reported as the region of interest (ROI) perfusion values and presented as curves, was compared between the affected and contralateral testicle. In testicles with normal blood circulation the ROI values increased during the imaging time. Nine patients were operated on, because the spermatic cord torsion could not be excluded by clinical or DUS findings.
  
  
  CONCLUSIONS
  All the normal testicles gave increasing ROI values meanwhile all three testicles with torsion gave constantly low values referring to no perfusion. Other causes of acute scrotum, such as epididymitis and torsion of testicular appendage seemed to be related with normal perfusion. Dynamic CE-MRI seems to show reliably ischemia of testicle and thus it may be helpful in selecting patients with acute scrotum for urgent operation.
authors: Paediatric Research Centre, Department of Pediatric Surgery, Tampere University Hospital, Tampere, Finland. eija.makela@pshp.fi
authors: E
authors: E
authors: Mäkelä
authors: T
authors: T
authors: Lahdes-Vasama
authors: P
authors: P
authors: Ryymin
authors: V
authors: V
authors: Kähärä
authors: J
authors: J
authors: Suvanto
authors: M
authors: M
authors: Kangasniemi
authors: A
authors: A
authors: Kaipia
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D003287:Contrast Media; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012611:Scrotum / Q000000981:diagnostic imaging / Q000473:pathology*; D013086:Spermatic Cord Torsion / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013733:Testicular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA