MR imaging of testicular torsion: Features of testicular hemorrhagic necrosis and clinical outcomes
Purpose To determine whether emergency subtraction dynamic contrast‐enhanced MR imaging (DCE‐MRI) in combination with T2‐ and T2*‐weighted imaging of the testis is useful in the evaluation of patients with testicular torsion. Materials and Methods Fourteen patients with surgically proven testicular...
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| Veröffentlicht in: | Journal of magnetic resonance imaging 2007-07, Vol.26 (1), p.100-108 |
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| creator | Watanabe, Yuji Nagayama, Masako Okumura, Akira Amoh, Yoshiki Suga, Tsuyoshi Terai, Akihito Dodo, Yoshihiro |
| description | Purpose
To determine whether emergency subtraction dynamic contrast‐enhanced MR imaging (DCE‐MRI) in combination with T2‐ and T2*‐weighted imaging of the testis is useful in the evaluation of patients with testicular torsion.
Materials and Methods
Fourteen patients with surgically proven testicular torsion were examined using preoperative emergency MRI, including T2‐weighted, T2*‐weighted, and DCE‐MRI. The affected testis was examined histologically in eight patients who underwent orchiectomy, and by postoperative follow‐up MRI in six patients who underwent orchiopexy. The diagnostic criteria for testicular torsion and detection of hemorrhagic necrosis in the affected testis in emergency MRI were decreased or no perfusion in DCE‐MRI and a spotty and/or streaky pattern of low or very low signal intensity in T2‐ and T2*‐weighted images. The intraoperative findings and clinical outcomes were also compared.
Results
The histological findings and follow‐up MR images revealed total or partial necrosis of the affected testis in 10 of the 14 patients. In the diagnosis of complete torsion, the sensitivities were 100% for DCE‐MRI and 75% for T2‐ and T2*‐weighted imaging. In the detection of testicular necrosis, T2‐ and T2*‐weighted imaging showed the highest accuracy (100%), followed by 12‐hour time from onset (93%), intraoperative findings (79%), and DCE‐MRI (71%).
Conclusion
Emergency MRI can help diagnose testicular torsion and detect testicular necrosis when DCE‐MRI is used in combination with T2‐ and T2*‐weighted images. J. Magn. Reson. Imaging 2007;26:100–108. © 2007 Wiley‐Liss, Inc. |
| doi_str_mv | 10.1002/jmri.20946 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68118925</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68118925</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4016-344dec2aa7b1ecc020d8b3f21ff505389311946a2d4d06d86eba6473632f45293</originalsourceid><addsrcrecordid>eNp9kE8vBDEYhxshluXiA0hPDpKhf6adGTc22GURQohL0-10VpmZ0s6E_fa6ZpE4OPVN-vx-ed8HgC2M9jBCZP-5cmaPoCzmS2ANM0IiwlK-HGbEaIRTlPTAuvfPCKEsi9kq6OGEs4yxdA2oixtoKjk19RTaAjbaN0a1pXSwsc4bWx_AEy2b1mn_5_9JV9a5pxBVsNbKWW88lHUOVWlqo2QJbdsoW2m_AVYKWXq9uXj74O7k-HYwjMZXp6PB4ThSMcI8onGca0WkTCZYK4UIytMJLQguChYOSTOKcbhRkjzOEc9TrieSxwnllBQxIxntg52u99XZtzZsKirjlS5LWWvbesFTjNOMsADuduB8a-90IV5dkOBmAiMxVyrmSsWX0gBvL1rbSaXzX3ThMAC4A95NqWf_VImzi5vRd2nUZYxv9MdPRroXwROaMHF_eSqOhg-PA3w-Ftf0ExuGkaQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68118925</pqid></control><display><type>article</type><title>MR imaging of testicular torsion: Features of testicular hemorrhagic necrosis and clinical outcomes</title><source>MEDLINE</source><source>Wiley Free Content</source><source>Wiley Online Library All Journals</source><creator>Watanabe, Yuji ; Nagayama, Masako ; Okumura, Akira ; Amoh, Yoshiki ; Suga, Tsuyoshi ; Terai, Akihito ; Dodo, Yoshihiro</creator><creatorcontrib>Watanabe, Yuji ; Nagayama, Masako ; Okumura, Akira ; Amoh, Yoshiki ; Suga, Tsuyoshi ; Terai, Akihito ; Dodo, Yoshihiro</creatorcontrib><description>Purpose
To determine whether emergency subtraction dynamic contrast‐enhanced MR imaging (DCE‐MRI) in combination with T2‐ and T2*‐weighted imaging of the testis is useful in the evaluation of patients with testicular torsion.
Materials and Methods
Fourteen patients with surgically proven testicular torsion were examined using preoperative emergency MRI, including T2‐weighted, T2*‐weighted, and DCE‐MRI. The affected testis was examined histologically in eight patients who underwent orchiectomy, and by postoperative follow‐up MRI in six patients who underwent orchiopexy. The diagnostic criteria for testicular torsion and detection of hemorrhagic necrosis in the affected testis in emergency MRI were decreased or no perfusion in DCE‐MRI and a spotty and/or streaky pattern of low or very low signal intensity in T2‐ and T2*‐weighted images. The intraoperative findings and clinical outcomes were also compared.
Results
The histological findings and follow‐up MR images revealed total or partial necrosis of the affected testis in 10 of the 14 patients. In the diagnosis of complete torsion, the sensitivities were 100% for DCE‐MRI and 75% for T2‐ and T2*‐weighted imaging. In the detection of testicular necrosis, T2‐ and T2*‐weighted imaging showed the highest accuracy (100%), followed by 12‐hour time from onset (93%), intraoperative findings (79%), and DCE‐MRI (71%).
Conclusion
Emergency MRI can help diagnose testicular torsion and detect testicular necrosis when DCE‐MRI is used in combination with T2‐ and T2*‐weighted images. J. Magn. Reson. Imaging 2007;26:100–108. © 2007 Wiley‐Liss, Inc.</description><identifier>ISSN: 1053-1807</identifier><identifier>EISSN: 1522-2586</identifier><identifier>DOI: 10.1002/jmri.20946</identifier><identifier>PMID: 17659558</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adolescent ; Adult ; Child ; Contrast Media ; Emergencies ; Hemorrhage - diagnosis ; Hemorrhage - surgery ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; MRI ; Necrosis ; Retrospective Studies ; Sensitivity and Specificity ; Subtraction Technique ; surgery ; Testicular Diseases - diagnosis ; Testicular Diseases - pathology ; Testicular Diseases - surgery ; testis ; Testis - blood supply ; Testis - pathology ; torsion ; Torsion Abnormality - diagnosis ; Torsion Abnormality - surgery</subject><ispartof>Journal of magnetic resonance imaging, 2007-07, Vol.26 (1), p.100-108</ispartof><rights>Copyright © 2007 Wiley‐Liss, Inc.</rights><rights>Copyright 2007 Wiley-Liss, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4016-344dec2aa7b1ecc020d8b3f21ff505389311946a2d4d06d86eba6473632f45293</citedby><cites>FETCH-LOGICAL-c4016-344dec2aa7b1ecc020d8b3f21ff505389311946a2d4d06d86eba6473632f45293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmri.20946$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmri.20946$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,1432,27923,27924,45573,45574,46408,46832</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17659558$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watanabe, Yuji</creatorcontrib><creatorcontrib>Nagayama, Masako</creatorcontrib><creatorcontrib>Okumura, Akira</creatorcontrib><creatorcontrib>Amoh, Yoshiki</creatorcontrib><creatorcontrib>Suga, Tsuyoshi</creatorcontrib><creatorcontrib>Terai, Akihito</creatorcontrib><creatorcontrib>Dodo, Yoshihiro</creatorcontrib><title>MR imaging of testicular torsion: Features of testicular hemorrhagic necrosis and clinical outcomes</title><title>Journal of magnetic resonance imaging</title><addtitle>J. Magn. Reson. Imaging</addtitle><description>Purpose
To determine whether emergency subtraction dynamic contrast‐enhanced MR imaging (DCE‐MRI) in combination with T2‐ and T2*‐weighted imaging of the testis is useful in the evaluation of patients with testicular torsion.
Materials and Methods
Fourteen patients with surgically proven testicular torsion were examined using preoperative emergency MRI, including T2‐weighted, T2*‐weighted, and DCE‐MRI. The affected testis was examined histologically in eight patients who underwent orchiectomy, and by postoperative follow‐up MRI in six patients who underwent orchiopexy. The diagnostic criteria for testicular torsion and detection of hemorrhagic necrosis in the affected testis in emergency MRI were decreased or no perfusion in DCE‐MRI and a spotty and/or streaky pattern of low or very low signal intensity in T2‐ and T2*‐weighted images. The intraoperative findings and clinical outcomes were also compared.
Results
The histological findings and follow‐up MR images revealed total or partial necrosis of the affected testis in 10 of the 14 patients. In the diagnosis of complete torsion, the sensitivities were 100% for DCE‐MRI and 75% for T2‐ and T2*‐weighted imaging. In the detection of testicular necrosis, T2‐ and T2*‐weighted imaging showed the highest accuracy (100%), followed by 12‐hour time from onset (93%), intraoperative findings (79%), and DCE‐MRI (71%).
Conclusion
Emergency MRI can help diagnose testicular torsion and detect testicular necrosis when DCE‐MRI is used in combination with T2‐ and T2*‐weighted images. J. Magn. Reson. Imaging 2007;26:100–108. © 2007 Wiley‐Liss, Inc.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>Contrast Media</subject><subject>Emergencies</subject><subject>Hemorrhage - diagnosis</subject><subject>Hemorrhage - surgery</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>MRI</subject><subject>Necrosis</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Subtraction Technique</subject><subject>surgery</subject><subject>Testicular Diseases - diagnosis</subject><subject>Testicular Diseases - pathology</subject><subject>Testicular Diseases - surgery</subject><subject>testis</subject><subject>Testis - blood supply</subject><subject>Testis - pathology</subject><subject>torsion</subject><subject>Torsion Abnormality - diagnosis</subject><subject>Torsion Abnormality - surgery</subject><issn>1053-1807</issn><issn>1522-2586</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE8vBDEYhxshluXiA0hPDpKhf6adGTc22GURQohL0-10VpmZ0s6E_fa6ZpE4OPVN-vx-ed8HgC2M9jBCZP-5cmaPoCzmS2ANM0IiwlK-HGbEaIRTlPTAuvfPCKEsi9kq6OGEs4yxdA2oixtoKjk19RTaAjbaN0a1pXSwsc4bWx_AEy2b1mn_5_9JV9a5pxBVsNbKWW88lHUOVWlqo2QJbdsoW2m_AVYKWXq9uXj74O7k-HYwjMZXp6PB4ThSMcI8onGca0WkTCZYK4UIytMJLQguChYOSTOKcbhRkjzOEc9TrieSxwnllBQxIxntg52u99XZtzZsKirjlS5LWWvbesFTjNOMsADuduB8a-90IV5dkOBmAiMxVyrmSsWX0gBvL1rbSaXzX3ThMAC4A95NqWf_VImzi5vRd2nUZYxv9MdPRroXwROaMHF_eSqOhg-PA3w-Ftf0ExuGkaQ</recordid><startdate>200707</startdate><enddate>200707</enddate><creator>Watanabe, Yuji</creator><creator>Nagayama, Masako</creator><creator>Okumura, Akira</creator><creator>Amoh, Yoshiki</creator><creator>Suga, Tsuyoshi</creator><creator>Terai, Akihito</creator><creator>Dodo, Yoshihiro</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200707</creationdate><title>MR imaging of testicular torsion: Features of testicular hemorrhagic necrosis and clinical outcomes</title><author>Watanabe, Yuji ; Nagayama, Masako ; Okumura, Akira ; Amoh, Yoshiki ; Suga, Tsuyoshi ; Terai, Akihito ; Dodo, Yoshihiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4016-344dec2aa7b1ecc020d8b3f21ff505389311946a2d4d06d86eba6473632f45293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>Contrast Media</topic><topic>Emergencies</topic><topic>Hemorrhage - diagnosis</topic><topic>Hemorrhage - surgery</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>MRI</topic><topic>Necrosis</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Subtraction Technique</topic><topic>surgery</topic><topic>Testicular Diseases - diagnosis</topic><topic>Testicular Diseases - pathology</topic><topic>Testicular Diseases - surgery</topic><topic>testis</topic><topic>Testis - blood supply</topic><topic>Testis - pathology</topic><topic>torsion</topic><topic>Torsion Abnormality - diagnosis</topic><topic>Torsion Abnormality - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Watanabe, Yuji</creatorcontrib><creatorcontrib>Nagayama, Masako</creatorcontrib><creatorcontrib>Okumura, Akira</creatorcontrib><creatorcontrib>Amoh, Yoshiki</creatorcontrib><creatorcontrib>Suga, Tsuyoshi</creatorcontrib><creatorcontrib>Terai, Akihito</creatorcontrib><creatorcontrib>Dodo, Yoshihiro</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of magnetic resonance imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Watanabe, Yuji</au><au>Nagayama, Masako</au><au>Okumura, Akira</au><au>Amoh, Yoshiki</au><au>Suga, Tsuyoshi</au><au>Terai, Akihito</au><au>Dodo, Yoshihiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>MR imaging of testicular torsion: Features of testicular hemorrhagic necrosis and clinical outcomes</atitle><jtitle>Journal of magnetic resonance imaging</jtitle><addtitle>J. Magn. Reson. Imaging</addtitle><date>2007-07</date><risdate>2007</risdate><volume>26</volume><issue>1</issue><spage>100</spage><epage>108</epage><pages>100-108</pages><issn>1053-1807</issn><eissn>1522-2586</eissn><abstract>Purpose
To determine whether emergency subtraction dynamic contrast‐enhanced MR imaging (DCE‐MRI) in combination with T2‐ and T2*‐weighted imaging of the testis is useful in the evaluation of patients with testicular torsion.
Materials and Methods
Fourteen patients with surgically proven testicular torsion were examined using preoperative emergency MRI, including T2‐weighted, T2*‐weighted, and DCE‐MRI. The affected testis was examined histologically in eight patients who underwent orchiectomy, and by postoperative follow‐up MRI in six patients who underwent orchiopexy. The diagnostic criteria for testicular torsion and detection of hemorrhagic necrosis in the affected testis in emergency MRI were decreased or no perfusion in DCE‐MRI and a spotty and/or streaky pattern of low or very low signal intensity in T2‐ and T2*‐weighted images. The intraoperative findings and clinical outcomes were also compared.
Results
The histological findings and follow‐up MR images revealed total or partial necrosis of the affected testis in 10 of the 14 patients. In the diagnosis of complete torsion, the sensitivities were 100% for DCE‐MRI and 75% for T2‐ and T2*‐weighted imaging. In the detection of testicular necrosis, T2‐ and T2*‐weighted imaging showed the highest accuracy (100%), followed by 12‐hour time from onset (93%), intraoperative findings (79%), and DCE‐MRI (71%).
Conclusion
Emergency MRI can help diagnose testicular torsion and detect testicular necrosis when DCE‐MRI is used in combination with T2‐ and T2*‐weighted images. J. Magn. Reson. Imaging 2007;26:100–108. © 2007 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>17659558</pmid><doi>10.1002/jmri.20946</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Child Contrast Media Emergencies Hemorrhage - diagnosis Hemorrhage - surgery Humans Image Processing, Computer-Assisted Magnetic Resonance Imaging - methods Male Middle Aged MRI Necrosis Retrospective Studies Sensitivity and Specificity Subtraction Technique surgery Testicular Diseases - diagnosis Testicular Diseases - pathology Testicular Diseases - surgery testis Testis - blood supply Testis - pathology torsion Torsion Abnormality - diagnosis Torsion Abnormality - surgery |
| title | MR imaging of testicular torsion: Features of testicular hemorrhagic necrosis and clinical outcomes |
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