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Imaging of segmental testicular infarction: our experience and literature review

L’imaging nell’infarto segmentale del testicolo: nostra esperienza e revisione della letteratura

  • Urogenital Radiology / Radiologia Uro-Genitale
  • Published:
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Abstract

Purpose

The purpose of this study was to evaluate the usefulness of the main methods of diagnostic imaging in patients with segmental testicular infarction (STI) for obtaining accurate clinical and therapeutic approaches.

Materials and methods

Between January 2004 and January 2011, 798 patients were examined with colour Doppler ultrasound (CDUS) for disease of the scrotum. Fourteen patients with CDUS findings suspicious for STI were subjected to magnetic resonance imaging (MRI). In five patients, contrast-enhanced ultrasonography (CEUS) was performed.

Results

CDUS showed hypoechoic avascular areas suspicious for STI in 14 patients (1.75%). MRI confirmed the presence of predominantly hypointense lesions in T1- and T2-weighted sequences, with perilesional vasculature and no intrinsic contrast enhancement in 13 patients. In follow-up examinations, these abnormalities gradually decreased. This finding was confirmed in the five patients examined with CEUS. Only in one case did MRI reveal discrete intralesional contrast enhancement after injection of contrast medium, and the lesions appeared stable during the CDUS and MRI follow-up; this patient underwent orchiectomy, with a diagnosis of B-cell lymphoma.

Conclusions

In our experience CDUS, CEUS and MRI proved indispensable for accurate clinical and therapeutic approaches in suspected STI.

Riassunto

Obiettivo

Scopo del lavoro è stato valutare l’utilità delle principali metodiche di diagnostica per immagini nel paziente con infarto segmentale del testicolo (IST) per un corretto approccio clinico-terapeutico.

Materiali e metodi

Nel periodo compreso tra gennaio 2004 e gennaio 2011 sono stati esaminati con eco-color Doppler (ECD) 798 pazienti per patologia dello scroto. Quattordici pazienti con reperti ECD sospetti per IST sono stati sottoposti a risonanza magnetica (RM). In 5 pazienti è stata eseguita ecografia con mezzo di contrasto (CEUS).

Risultati

Quattordici pazienti (1,75%) presentavano aree ipoecogene avascolari sospette per IST all’indagine ECD. L’RM ha confermato la presenza di lesioni prevalentemente ipointense nelle sequenze dipendenti dal T1 e dal T2, prive di contrast enhancement e con vascolarizzazione principalmente perilesionale in 13 pazienti. Nel follow-up queste alterazioni si sono progressivamente ridotte. Il dato è stato confermato anche mediante CEUS in 5 pazienti. Solo in 1 caso la RM ha documentato un discreto contrast enhancement delle lesioni e, vista la stazionarietà del reperto ECD e RM al follow-up, il paziente è stato sottoposto a orchiectomia, con diagnosi di linfoma a cellule B.

Conclusioni

Dalla nostra esperienza ECD, CEUS e RM si sono dimostrate metodiche indispensabili per un corretto approccio clinico-terapeutico nel sospetto di IST.

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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

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

    M. Sartoni, E. Gaddoni, P. Campioni & P. Mannella

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

    S. Zago

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  1. G. C. Parenti
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  2. M. Sartoni
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  3. E. Gaddoni
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  5. P. Campioni
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Correspondence to G. C. Parenti.

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Parenti, G.C., Sartoni, M., Gaddoni, E. et al. Imaging of segmental testicular infarction: our experience and literature review. Radiol med 117, 1161–1175 (2012). https://doi.org/10.1007/s11547-012-0798-6

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  • DOI: https://doi.org/10.1007/s11547-012-0798-6

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