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ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN

Year 2018, , 192 - 197, 31.08.2018
https://doi.org/10.24938/kutfd.408215

Abstract

Objective: The aim of this study was to investigate the contribution of quantitative apparent diffusion coefficient (ADC) measurements in the diagnosis of testis torsion.

Material and Methods: The study included 28 patients that underwent a magnetic resonance imaging (MRI) scan between January 2013 and June 2017 due to acute scrotal pain. Definitive diagnosis was based on the symptom assessment, treatment, and follow-up of the patients. Based on these parameters, patients were categorized into groups and quantitative ADC values were compared among these groups.

Results: Of the patients included in the study, 9 were diagnosed with epididymitis, 9 with orchitis, and 10 with testis torsion. The mean ADC values in the affected testes of testis torsion, epididymitis, and orchitis groups were 0.763 ± 0.154 X 10-3 mm2/s, 1.050 ± 0.850 X 10-3 mm2/s, and 1.105 ± 0.218 X 10-3 mm2/s, respectively. The mean ADC values of the affected testes were significantly lower in the testis torsion group compared to the other groups (p<0.01). In the testis torsion group, the mean ADC value of the affected testes was significantly lower compared to the unaffected testes (0.763 ± 0.154 X 10-3 mm2/s vs 1.053 ± 0.147 X 10-3 mm2/s, p<0.05, respectively).

ConclusionDoppler ultrasound has been used as the first choice in diagnosis of acute scrotal pain due to its being a rapid and convenient imaging modality. Quantitative ADC measurements, can be used as a helpful additional tool for the diagnosis and differential diagnosis of testis torsion from other acute scrotal pain conditions such as epididymitis or orchitis.

References

  • 1. Patriquin HB, Yazbeck S, Trinh B, Jéquier S, Burns PN, Grignon A et al. Testicular torsion in infants and children: diagnosis with doppler sonography. Radiology. 1993;188(3):781-5.
  • 2. Luker GD, Siegel MJ. Color Doppler sonography of the scrotum in children. AJR Am J Roentgenol. 1994;163(3):649-55.
  • 3. Pepe P, Panella P, Pennisi M, Aragona F. Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? Eur J Radiol. 2006;60(1):120-4.
  • 4. Yagil Y, Naroditsky I, Milhem J, Leiba R, Leiderman M, Badaan S et al. Role of Doppler ultrasonography in the triage of acute scrotum in the emergency department. J Ultrasound Med. 2010;29(1):11-21.
  • 5. Maki D, Watanabe Y, Nagayama M, Ishimori T, Okumura A, Amoh Y et al. Diffusion-weighted magnetic resonance imaging in the detection of testicular torsion: feasibility study. J Magn Reson Imaging. 2011;34(5):1137-42.
  • 6. Beyazal M, Avcu S, Celiker FB, Yavuz A, Toktas O. The efficiency of apparent diffusion coefficient quantification in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening. Jpn J Radiol. 2014;32(9):545-51.
  • 7. Ufuk F, Herek D, Herek O, Akbulut M. Role of diffusion weighted magnetic resonance imaging in a rat model of testicular torsion. Br J Radiol. 2016;89(1068):20160585.
  • 8. Kangasniemi M, Kaipia A, Joensuu R. Diffusion weighted magnetic resonance imaging of rat testes: a method for early detection of ischemia. J Urol. 2001;166(6):2542-4.
  • 9. Atkinson GO Jr, Patrick LE, Ball TI Jr, Stephenson CA, Broecker BH, Woodard JR. The normal and abnormal scrotum in children: evaluation with color Doppler sonography. AJR Am J Roentgenol. 1992;158(3):613-7.
  • 10. Padhani AR, Liu G, Koh DM, Chenevert TL, Thoeny HC, Takahara T et al. Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia. 2009;11(2):102-25.
  • 11. Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol. 2007;188(6):1622-35.
  • 12. Avcu S, Bulut MD, Yavuz A, Bora A, Beyazal M. Value of DWMRI ADC quantification of colonic wall lesions in differentiation of inflammatory bowel disease and colorectal carcinoma. Jpn J Radiol. 2014;32(1):6-13.
  • 13. Kaipia A, Ryymin P, Mäkelä E, Aaltonen M, Kähärä V, Kangasniemi M. Magnetic resonance imaging of experimental testicular torsion. Int J Androl. 2005;28(6):355-9.
  • 14. Terai A, Yoshimura K, Ichioka K, Ueda N, Utsunomiya N, Kohei N et al. Dynamic contrast-enhanced subtraction magnetic resonance imaging in diagnostics of testicular torsion. Urology. 2006;67(6):1278-82.
  • 15. Watanabe Y, Nagayama M, Okumura A et al. MR imaging of testicular torsion: features of testicular hemorrhagic necrosis and clinical outcomes. J Magn Reson Imaging. 2007;26(1):100-8.
  • 16. Trambert MA, Mattrey RF, Levine D, Berthoty DP. Subacute scrotal pain: evaluation of torsion versus epididymitis with MR imaging. Radiology. 1990;175(1):53-6.
  • 17. Mäkelä E, Lahdes-Vasama T, Ryymin P, Kähärä V, Suvanto J, Kangasniemi M et al. Magnetic resonance imaging of acute scrotum. Scand J Surg. 2011;100(3):196-201.

Akut Skrotal Ağrıda Difüzyon Ağırlıklı Manyetik Rezonans Görüntülemenin Rolü

Year 2018, , 192 - 197, 31.08.2018
https://doi.org/10.24938/kutfd.408215

Abstract


AmaçBu çalışmanın amacı, testis torsiyonunun tanısında kantitatif görünür difüzyon katsayısı (GDK) ölçümlerinin katkısını araştırmaktır.

Gereç ve YöntemlerOcak 2013 ile Haziran 2017 tarihleri arasında akut skrotum kliniği nedeniyle ile manyetik rezonans görüntüleme yapılan 28 hasta (ortalama yaş: 37.7 ± 21.4) çalışmaya dahil edildi. Hastaların tanı, tedavi ve takiplerine dayanarak nihai tanısı belirlendi ve gruplara ayrıldı. Bu grupların difüzyon ağırlıklı görüntüleri ve GDK değerleri karşılaştırıldı.

BulgularÇalışmaya dahil edilen hastaların 9’u epidimit, 9’u orşit, 10’u testis torsiyonu idi. Testis torsiyonu olan 10 hastanın 5’ine orşiektomi, 5’ine orşiopeksi uygulandı. Geri kalan 18 hastanın 9’u epididimit, 9’ü orşit tanısı ile medikal olarak tedavi edildi. Testis torsiyonu, epididimit ve orşit gruplarının etkilenmiş testislerinin ortalama GDK değerleri sırası ile 0.763 ± 0.154x10-3 mm2/s, 1.050 ± 0.850x10-3 mm2/s ve 1.105 ± 0.218x10-3 mm2/s ölçüldü. Etkilenmiş testislerde testis torsiyonu grubunun ortalama GDK değerleri diğer gruplardan anlamlı olarak daha düşük bulundu (p<0.01). Ancak epididimit ve orşit arasında anlamlı farklılık saptanmadı (p>0.05). Ayrıca testis torsiyonu grubunda etkilenmiş ve etkilenmemiş testislerin ortalama GDK değerleri sırası ile 0.763 ± 0.154 X 10-3 mm2/s, 1.053 ± 0.147x10-3 mm2/s ölçüldü ve etkilenmiş tarafta ortalama GDK değerleri etkilenmemiş taraftaki testislerden anlamlı olarak düşük bulundu (p <0.05).

Sonuç: Doppler ultrason hızlı olması ve kolay uygulanabilirliği nedeni ile akut skrotal ağrının tanısında ilk tercih olarak kullanılmaktadır. Ancak kantitatif GDK ölçümleri testis torsiyonu tanısında ve epididimit ile orşit gibi diğer akut skrotal ağrıların ayırıcı tanısında yardımcı ek bir araç olarak kullanılabilir.

References

  • 1. Patriquin HB, Yazbeck S, Trinh B, Jéquier S, Burns PN, Grignon A et al. Testicular torsion in infants and children: diagnosis with doppler sonography. Radiology. 1993;188(3):781-5.
  • 2. Luker GD, Siegel MJ. Color Doppler sonography of the scrotum in children. AJR Am J Roentgenol. 1994;163(3):649-55.
  • 3. Pepe P, Panella P, Pennisi M, Aragona F. Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? Eur J Radiol. 2006;60(1):120-4.
  • 4. Yagil Y, Naroditsky I, Milhem J, Leiba R, Leiderman M, Badaan S et al. Role of Doppler ultrasonography in the triage of acute scrotum in the emergency department. J Ultrasound Med. 2010;29(1):11-21.
  • 5. Maki D, Watanabe Y, Nagayama M, Ishimori T, Okumura A, Amoh Y et al. Diffusion-weighted magnetic resonance imaging in the detection of testicular torsion: feasibility study. J Magn Reson Imaging. 2011;34(5):1137-42.
  • 6. Beyazal M, Avcu S, Celiker FB, Yavuz A, Toktas O. The efficiency of apparent diffusion coefficient quantification in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening. Jpn J Radiol. 2014;32(9):545-51.
  • 7. Ufuk F, Herek D, Herek O, Akbulut M. Role of diffusion weighted magnetic resonance imaging in a rat model of testicular torsion. Br J Radiol. 2016;89(1068):20160585.
  • 8. Kangasniemi M, Kaipia A, Joensuu R. Diffusion weighted magnetic resonance imaging of rat testes: a method for early detection of ischemia. J Urol. 2001;166(6):2542-4.
  • 9. Atkinson GO Jr, Patrick LE, Ball TI Jr, Stephenson CA, Broecker BH, Woodard JR. The normal and abnormal scrotum in children: evaluation with color Doppler sonography. AJR Am J Roentgenol. 1992;158(3):613-7.
  • 10. Padhani AR, Liu G, Koh DM, Chenevert TL, Thoeny HC, Takahara T et al. Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia. 2009;11(2):102-25.
  • 11. Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol. 2007;188(6):1622-35.
  • 12. Avcu S, Bulut MD, Yavuz A, Bora A, Beyazal M. Value of DWMRI ADC quantification of colonic wall lesions in differentiation of inflammatory bowel disease and colorectal carcinoma. Jpn J Radiol. 2014;32(1):6-13.
  • 13. Kaipia A, Ryymin P, Mäkelä E, Aaltonen M, Kähärä V, Kangasniemi M. Magnetic resonance imaging of experimental testicular torsion. Int J Androl. 2005;28(6):355-9.
  • 14. Terai A, Yoshimura K, Ichioka K, Ueda N, Utsunomiya N, Kohei N et al. Dynamic contrast-enhanced subtraction magnetic resonance imaging in diagnostics of testicular torsion. Urology. 2006;67(6):1278-82.
  • 15. Watanabe Y, Nagayama M, Okumura A et al. MR imaging of testicular torsion: features of testicular hemorrhagic necrosis and clinical outcomes. J Magn Reson Imaging. 2007;26(1):100-8.
  • 16. Trambert MA, Mattrey RF, Levine D, Berthoty DP. Subacute scrotal pain: evaluation of torsion versus epididymitis with MR imaging. Radiology. 1990;175(1):53-6.
  • 17. Mäkelä E, Lahdes-Vasama T, Ryymin P, Kähärä V, Suvanto J, Kangasniemi M et al. Magnetic resonance imaging of acute scrotum. Scand J Surg. 2011;100(3):196-201.
There are 17 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Mehmet Beyazal

Hasan Rıza Aydın

Maksude Esra Kadıoğlu This is me

Fatma Beyazal Çeliker

Mehmet Fatih İnecikli

Tuğba Eldeş This is me

Hüseyin Eren This is me

Publication Date August 31, 2018
Submission Date March 20, 2018
Published in Issue Year 2018

Cite

APA Beyazal, M., Aydın, H. R., Kadıoğlu, M. E., Beyazal Çeliker, F., et al. (2018). ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN. The Journal of Kırıkkale University Faculty of Medicine, 20(2), 192-197. https://doi.org/10.24938/kutfd.408215
AMA Beyazal M, Aydın HR, Kadıoğlu ME, Beyazal Çeliker F, İnecikli MF, Eldeş T, Eren H. ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN. Kırıkkale Üni Tıp Derg. August 2018;20(2):192-197. doi:10.24938/kutfd.408215
Chicago Beyazal, Mehmet, Hasan Rıza Aydın, Maksude Esra Kadıoğlu, Fatma Beyazal Çeliker, Mehmet Fatih İnecikli, Tuğba Eldeş, and Hüseyin Eren. “ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN”. The Journal of Kırıkkale University Faculty of Medicine 20, no. 2 (August 2018): 192-97. https://doi.org/10.24938/kutfd.408215.
EndNote Beyazal M, Aydın HR, Kadıoğlu ME, Beyazal Çeliker F, İnecikli MF, Eldeş T, Eren H (August 1, 2018) ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN. The Journal of Kırıkkale University Faculty of Medicine 20 2 192–197.
IEEE M. Beyazal, H. R. Aydın, M. E. Kadıoğlu, F. Beyazal Çeliker, M. F. İnecikli, T. Eldeş, and H. Eren, “ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN”, Kırıkkale Üni Tıp Derg, vol. 20, no. 2, pp. 192–197, 2018, doi: 10.24938/kutfd.408215.
ISNAD Beyazal, Mehmet et al. “ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN”. The Journal of Kırıkkale University Faculty of Medicine 20/2 (August 2018), 192-197. https://doi.org/10.24938/kutfd.408215.
JAMA Beyazal M, Aydın HR, Kadıoğlu ME, Beyazal Çeliker F, İnecikli MF, Eldeş T, Eren H. ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN. Kırıkkale Üni Tıp Derg. 2018;20:192–197.
MLA Beyazal, Mehmet et al. “ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN”. The Journal of Kırıkkale University Faculty of Medicine, vol. 20, no. 2, 2018, pp. 192-7, doi:10.24938/kutfd.408215.
Vancouver Beyazal M, Aydın HR, Kadıoğlu ME, Beyazal Çeliker F, İnecikli MF, Eldeş T, Eren H. ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN ACUTE SCROTAL PAIN. Kırıkkale Üni Tıp Derg. 2018;20(2):192-7.

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