The Efficacy of Magnetic Resonance Imaging for the Diagnosis of Testicular Rupture: A Prospective Preliminary Study

Background: Magnetic resonance imaging (MRI) scan is useful for the evaluation of the testis because of high soft-tissue contrast and its multiplanar capability. The purpose of this study was to evaluate prospectively the efficacy of MRI for the diagnosis of testicular rupture in blunt scrotal trauma. Methods: From January to December 2006, seven consecutive patients (mean age 22 years, range 21-23 years) that presented with blunt scrotal trauma were enrolled in this prospective study. The patients underwent scrotal sonography (US), and supplementary MRI was performed before exploratory surgery. The essential sequences of the MRI were T2-weighted coronal, axial, and sagittal scans. The diagnostic accuracy of MRI was evaluated by means of the surgical findings as the reference standard. Results: The diagnostic accuracy of MRI was 100% (7 of 7). Three cases with testicular rupture were diagnosed accurately. Interruption of the dark signal intensity line of the tunica albuginea was pathognomonic for the diagnosis of testicular rupture. Two cases with an inconclusive diagnosis after US were accurately diagnosed as epididymal hematomas. The remaining two cases also showed concordant results with the surgical findings. Conclusions. MRI can be a useful alternative diagnostic modality for blunt scrotal trauma in limited conditions, especially under circumstances where the use of US infrequently results in an inconclusive diagnosis.