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Role of MRI diffusion and apparent diffusion coefficient values in characterization of scrotal lesions

Wageeh A. Ali MD

 Background: Despite scrotal Ultrasound remains the gold standard imaging method in the diagnosis of scrotal lesions. Magnetic resonance (MR) imaging of the scrotum may offer appreciated information in the recognition and interpretation of different scrotal lesions. MR evaluation of the scrotum achieves well in focusing scrotal masses; hence, discriminating intra-testicular and extra-testicular scrotal lesions. The benefits of MRI are orchestrated imaging of both testicles and both inguinal regions, acquisition of adequate anatomic information, and   acceptable tissue contrast. A preoperative characterization of the histological nature of numerous scrotal masses is also conceivable in many cases.

This study aimed to evaluate the role of MR diffusion weighted (DWI) and apparent diffusion coefficient (ADC values) in characterization of scrotal lesions.

Results: There was a significant difference between ADC values of malignant testicular lesions and normal testicular tissues as well as benign testicular lesions (P=0.000). At a cut-off ADC value of ≤1.1, it had a sensitivity of 86.4%, specificity of 97.4%, positive predictive value of 95%, and negative predictive value of 92.5% in the characterization of intratesticular masses.

Conclusion: Diffusion weighted images, ADC value and conventional MRI imaging can help differentiate between benign and malignant scrotal lesions and exclude the unnecessary drastic orchiectomy

Key words: DWI: Diffusion weighted imaging; ADC: Apparent diffusion coefficient: scrotal lesions.