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Imaging of the scrotum: role of MRI

L’imaging dello scroto: ruolo della RM

  • Uro-Genital Radiology/Radiologia Uro-Genitale
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the usefulness of imaging for correct clinical and therapeutic management of patients with scrotal disease.

Materials and methods

Between 2000 and 2007, 801 patients with suspected scrotal disease underwent colour Doppler ultrasonography (CDUS) at our centre. In 46 patients, the CDUS study was followed by magnetic resonance imaging (MRI).

Results

CDUS revealed an inflammatory process in 277 patients (34.58%), testicular trauma in 112 (13.9%), funicular torsion or torsion of the vestigial remnant in 44 (5.4%), findings suggestive of testicular neoplasm in 35 (4.3%) and no abnormality in 41.5%. MRI, used to further investigate the CDUS findings in 46 cases, showed three cases of intraparenchymal haematoma, one of intrascrotal cavernous body rupture, one of testicular abscess with intrascrotal fistula, two of testicular infarction and 15 of neoplasm. MRI allowed the exclusion of focal abnormalities in ten patients with testicular microlithiasis, in three with chronic orchitis and in four with atrophic involution. MRI confirmed the finding of inguinal hernia in three cases.

Conclusions

On the basis of our experience, CDUS is irreplaceable as an initial approach to patients affected by scrotal disease, whereas MRI is an ideal second-line investigation. MRI offers useful, and in some cases decisive, information, as it is capable of revealing unexpected findings and elucidating complex aspects. MRI helps improve patient management, with an overall reduction in costs.

Riassunto

Obiettivo

Scopo del lavoro è stato quello di valutare l’utilitá delle metodiche di immagine nei pazienti con patologia dello scroto per un corretto approccio clinico-terapeutico.

Materiali e metodi

Ottocentouno pazienti sono stati sottoposti ad indagine eco-color Doppler (ECD) e successivamente 46 pazienti sono stati indagati con risonanza magnetica (RM).

Risultati

L’ECD ha rilevato: in 277 pazienti (34,58%) processo flogistico, in 112 (13,9%) trauma del testicolo, in 44 (5,4%) torsione del funicolo o di un residuo embrionario, in 35 (4,3%) alterazioni riconducibili ad eteroplasia testicolare mentre nel 41,5% non erano presenti alterazioni patologiche. In 46 casi si è ricorsi alla RM per chiarimento o miglior definizione diagnostica del reperto ECD rilevando: 3 casi di ematoma intraparenchimale, 1 caso di rottura intrascrotale del corpo cavernoso, 1 caso di ascesso testicolare con fistola intrascrotale, 2 casi di infarto, 15 casi di eteroplasia. Inoltre ha permesso di escludere alterazioni focali in 10 pazienti affetti da microlitiasi testicolare (MT), in 3 con orchite cronica e in 4 con involuzione atrofica. In 3 casi ha confermato il reperto di ernia inguinale.

Conclusioni

Dalla nostra esperienza l’indagine ECD appare di insostituibile utilitá nel primo approccio ai pazienti con patologia scrotale e l’indagine RM rappresenta un ideale metodica di secondo livello. La RM è utile in casi selezionati, potendo rilevare situazioni complesse e precedentemente insospettabili, risultando in un miglioramento della gestione del paziente e in un contenimento globale dei costi.

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Authors and Affiliations

  1. U.O. Radiodiagnostica, Ospedale Civile “S. Maria delle Croci”, V.le Randi 5, 48100, Ravenna, Italy

    G.C. Parenti, D. Palmarini & A. Ginevra

  2. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Ferrara, Corso Giovecca 203, 44100, Ferrara, Italy

    F. Feletti & F. Brandini

  3. Servizio di Anatomia Patologica, Ospedale Civile “S.Maria delle Croci”, V.le Randi 5, 48100, Ravenna, Italy

    S. Zago

  4. Istituto di Radiodiagnostica, Università degli Studi di Ferrara, Corso Giovecca 203, 44100, Ferrara, Italy

    P. Campioni & P. Mannella

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  1. G.C. Parenti
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  2. F. Feletti
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Correspondence to G.C. Parenti.

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Parenti, G., Feletti, F., Brandini, F. et al. Imaging of the scrotum: role of MRI. Radiol med 114, 414–424 (2009). https://doi.org/10.1007/s11547-009-0377-7

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  • DOI: https://doi.org/10.1007/s11547-009-0377-7

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