Value of diffusion weighted magnetic resonance imaging in diagnosis and characterization of scrotal abnormalities

MRI of scrotal lesions represents an important diagnostic tool in the evaluation of scrotal diseases. Diffusion weighted (DW) MR imaging is a promising technique which proved to improve tissue characterization. To assess the diagnostic value and role of DWMR imaging in the detection and characterization of scrotal lesions. A prospective study included 50 scrotal lesions (35 intratesticular and 15 extra testicular) with 50 normal testes used as control. DW sequences were obtained using a b factor of 0, 500 and 900s/mm22. The accuracy of conventional sequences, DW images alone and DW imaging combined with conventional images in differentiating benign from malignant scrotal lesions was calculated. There was significant difference between apparent diffusion coefficient (ADC) values of testicular malignancies, normal testis and benign intratesticular lesions, and the ADC values of benign extra testicular lesions from those of normal epididymis. The overall accuracy of conventional imaging, DW imaging alone and DWMR combined with conventional sequences in the characterization of intratesticular lesions was 90%, 87% and 100%, respectively. Our findings suggest that DWMR imaging and ADC values may provide valuable information in the diagnosis and characterization of scrotal diseases.