Magnetic resonance imaging for detection of non palpable undescended testes: Diagnostic accuracy of diffusion-weighted MRI in comparison with laparoscopic findings

Purpose: The purpose of this study is to assess the value of adding diffusion-weighted sequences (DW) to routine magnetic resonance imaging (MRI) in identifying and locating nonpalpable undescended testes. Materials and methods: This prospective study included 51 patients with age ranges from 2 to 15 years presenting with non-palpable undescended testes. MRI was done using1.5 MRI machine. MRI examination included axial and coronal spin-echo T1-weighted sequence, axial and coronal fat suppressed spin-echo T2-weighted sequence and axial DWI. Images were interpreted for the presence or absence and the location of the undescended testes. Testes were recognized by their elliptical shape and hyperintensity. Testes were classified into three anatomic regions: intracanalicular, low intra-abdominal, and high intra-abdominal. Laparoscopy was used as a gold standard. Results: Conventional MRI showed a sensitivity, specificity and accuracy of 87.23%, 50% and 83% respectively. DW MRI showed a sensitivity, specificity and accuracy of 91.5%, 66.7% and 88.6% respectively. The combined usage of conventional and DW MRI yielded a sensitivity, specificity and accuracy of 95.8%, 100% and 96.2%. Conclusion: DWI especially performed at a high b value improves detection of undescended testes. (C) 2014 The Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B.V. All rights reserved.