MRI versus ultrasound in localization of undescended testicles

Abstract EN

Introduction : Undescended testis is a major clinical problem in male infants as long-term retention of undescended testis is associated with dramatically increased risk of testicular neoplasm, especially seminoma.

In addition, undescended testis will alter the male fertility.

Aim of the work : To compare the results of the two imaging modalities (US & MRI) in localization of undescended testicles to chose the line of treatment.

Patients and Methods : Our current study included 30 male patients with age range between 3 months up to 25 years.

Clinically, the undescended testicle was RT.

Sided in 12 patients (40 %), LT.

sided in 10 patients (33.3 %) and bilateral in 8 patients (26.7 %).

All the 30 patients were examined firstly with ultrasound followed by MRI.

The findings were recorded and compared based on surgical findings.

Results : US succeeded in localizing the undescended testis in 25 cases (25 / 30 = 83.3 %) and did not detect 5 cases (5 / 30 = 16.7 %).

12 cases were atrophied on US (12 / 30 = 40 %).

Sensitivity was.

(89.3.6 %), specificity (100 %) and accuracy (90 %).

The US locations of the 25 cases were 14 cases within inguinal canal, 7 cases adjacent to the superficial inguinal ring & 4 cases adjacent to the internal inguinal ring.

MRI succeeded in localizing the undescended testis in 28 cases (28 / 30 = 93.3 %) and did not detect 2 cases (6.7 %), anorchia (testicular agenesis).

16 cases were atrophied on MRI (53.3 %).

Sensitivity was (100 %), specificity (100 %) and accuracy (100 %).The MRI location of the detected cases were 15 cases within inguinal canal (15 / 30 = 50 %), 8 cases adjacent to superficial inguinal ring (8 / 30 = 26.7 %) & 4 cases adjacent to internal inguinal ring (4 / 30 = 13.3 %) and one case was ectopic intra-abdominal.

On surgery 28 undescended testicles were detected (consuistent with MRI findings).

2 cases were truly absent (agenesis) on exploration.

Conclusion : MRI is a new modality for localization of undescended testicles because; it is safe, multiplanar & high resolution.

MRI with IV contrast injection is helpful especially in suspected cases with atrophy.

Ultrasound must be used first, as both modalities are complementary to each other.