Testicular MRI: Beyond malignancy

Congress:

ECR 2018

Poster Number:

C-2512

Type:

Educational Exhibit

Keywords:

Genital / Reproductive system male, Abdomen, MR, Contrast agent-intravenous, Neoplasia, Inflammation, Ischaemia / Infarction

Authors:

F. Bosch Barragan¹, B. Consola¹, M. PITARCH DIAGO¹, A. B. A. B. CASTRO GARCIA², J. Puig Domingo³, J. Martin Martinez¹; ¹Sabadell/ES, ²BARCELONA/ES, ³Sabadell, Barcelona/ES

DOI:

10.1594/ecr2018/C-2512

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-2512

Fig. 13: 42-year-old man with acute scrotal pain in left testicle. A ) Gray-scale...

Table 1

Fig. 1: Testicular pain in a 20-year-old man. A ) US image shows a well-defined and...

Fig. 2: Painless left testicular mass in a 31 year-old man. A ) US image shows a solid...

Learning objectives

To review the current role of magnetic resonance imaging (MRI) in testicular lesions and its indications. To show the characteristic MRI findings for benign and malignant conditions involving the testes.

Background

In recent years, MRI has proven useful in the diagnosis of testicular lesions. In the classical approach to testicular lesions, ultrasound is the imaging modality of choice because of its accessibility and ability to establish a diagnosis in most cases. Computed tomography (CT) has a role in the study of the extent of testicular cancer. Given the widespread use of plain-film chest X-rays, they are occasionally the first imaging test in patients with testicular cancer detected after the discovery of lung metastases. MRI has a...

Findings and procedure details

The MRI protocol for testicular lesions usually includes T1-weighted sequences (with or without fat-sat), T2-weighted sequences, and gadolinium-enhanced T1 fat-sat sequences (all in different spatial planes). Compared to striated muscle, normal testes are isointense (homogeneous intermediate) at T1 and hyperintense at T2; normal testes show homogeneous uptake of contrast material. Intratesticular lesions can be classified as benign, malignant, or pseudolesions. Most solid intratesticular lesions are malignant (Table 1). 1.Benign lesions Testicular cyst MRI findings: circumscribed lesions located within the testis itself or in the tunica...

Conclusion

MRI is a useful complementary test in the diagnosis of testicular lesions in cases where ultrasound is inconclusive. The advantages of MRI are especially evident in benign lesions and pseudolesions. The behavior of malignant lesions varies; nevertheless, there are differences in the radiologic appearance of the different types of tumors.

Personal information

References

Cassidy, F. H., Ishioka, K. M., McMahon, C. J., Chu, P., Sakamoto, K., Lee, K. S., & Aganovic, L. (2010). MR Imaging of Scrotal Tumors and Pseudotumors. RadioGraphics, 30(3), 665–683. https://doi.org/10.1148/rg.303095049 Coursey Moreno, C., Small, W. C., Camacho, J. C., Master, V., Kokabi, N., Lewis, M., … Mittal, P. K. (2015). Testicular Tumors: What Radiologists Need to Know—Differential Diagnosis, Staging, and Management. RadioGraphics, 35(2), 400–415. https://doi.org/10.1148/rg.352140097 Fernández, G. C., Tardáguila, F. M., Rivas, C., Meijide, F., Miguel, P. S., & Fuente, A. de la. (2001)....