Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of non‐palpable testis

Abstract

Background : Studies were needed to evaluate the accuracy of ultrasonography (US) and magnetic resonance imaging (MRI) for diagnosing non-palpable testis, and to study the clinical usefulness of US and MRI before surgical exploration. Methods : Fifty-six patients with non-palpable testis aged 1-12 years were examined between 1993 and 2002. Forty-six patients (55 non-palpable testes) underwent US. Forty patients (47 non-palpable testes) were examined using MRI. Both US and MRI were used in 29 patients (34 non-palpable testes). We used Fisher's exact probability test to compare the results of these graphic examinations with the surgical or laparoscopic findings for the non-palpable testis.Results : Ultrasonography had a sensitivity of 76%, a specificity of 100%, and an accuracy of 84% in the diagnosis of non-palpable testis, whereas MRI had a sensitivity of 86%, a specificity of 79%, and an accuracy of 85%.Conclusions : There were no statistically significant differences in the accuracy rates of US and MRI for diagnosing non-palpable testis. Laparoscopy or inguinal exploration should be performed even if these graphic examinations demonstrate the absence of a testis, because some patients with a nonpalpable testis were found to be false negatives. We recommend US as the first step after clinical examination, and MRI could be performed when the US findings are negative preoperatively for a non-palpable testis.

Role of Diffusion-Weighted Magnetic Resonance Imaging in Detection of Non-Palpable Undescended Testes.

“…The accuracy of detection of the location of a nonpalpable testis with MRI and ultrasound are similar about (85% and 84% respectively) (6,8). Many recent studies have noted that combining DWI with routine MRI sequences improves the diagnostic accuracy of the procedure (9)(10)(11)(12)(13)(14)(15)(16)(17).…”

“…Many studies concluded that the accuracy of US was not satisfactory (6). Different radiological diagnostic procedures before laparoscopic intervention for non-palpable testis are still controversial regarding the cost benefit ratio.…”

“…Laparoscopy has been considered the most reliable and accurate diagnostic procedure for the identification of nonpalpable testes however being an invasive procedure is the main disadvantage [6].…”

Magnetic Resonance Imaging for Locating Nonpalpable Undescended Testicles: A Meta-analysis

“…Of these, 8 unique studies, all prospective case series addressing the performance of MRI before surgery in identifying and locating nonpalpable undescended testicles, were selected for the metaanalysis. [12][13][14][15][16][17][18][19] All studies were conducted in the hospital setting with more studies conducted in Asia (n = 5) than in the United States (n = 1) or in Europe (n = 2). The number of participants in each study ranged from 14 to 40; the …”

“…None of the studies reported any complication attributable to the imaging procedures. Pediatric urologists 13 or pediatric surgeons 19 or physicians 16 were reported to have conducted the preoperative physical examination in these included studies, although 63% did not note who completed the examination.…”