陰囊及睪丸之病症在臨床診斷上主要靠詳細病史和理學檢查。自從高頻超音波之使用後,超音波即成為第一線診斷工具。然而,核磁共振造影更可以提供陰囊內睪丸、副睪丸、精索、及陰囊內病變之多平面顯示和更詳細的解剖影像診斷,同時亦不需要特別技巧。從1994年七月到1996年七月,共收集三十位男性(11歲到79歲)皆主訴陰囊不適包括一位自願者,先做事前的超音波檢查,再接受陰囊核磁共振造影(機型:GE system 1.5T和surface coil)得到Ti和T2影像,並加入顯影劑(Gd-DTPA)來鑑別診斷。其中五位為隱睪症、三位為睪丸內腫瘤、一位睪丸外腫瘤、三位陰囊外傷、五位陰囊缺血、六位陰囊發炎、一位血管疾病、三位精索靜脈曲張、和疝氣、陰囊水囊各一人。其中,超音波在隱睪、陰囊病變的位置確定和診斷上只有90%正確性。核磁共振造影在診斷上則有100%之敏感度、正確性及專一性。所有病灶皆可在T2影像中發現,加強顯影後之影像又尤其對睪丸缺血和陰囊內病灶的診斷具有鑑別能力。總之,核磁共振造影能提供較專一性和免除疼痛之檢查,同時又不俱有放射線。亦可以事先經由核磁共振造影瞭解病灶特性,用來避免不必要之手術或是在隱睪症治療上可以術前計劃選擇何種的手術方式。
From July 1994 to July 1996, 29 men with scrotal diseases and one normal volunteer, all aged 11 to 79 years, underwent MRI examination and previous ultrasonographic (7.5 MHz) study. A GE Signa 1.5-T system and surface coil were used to obtain T1-and T2-weighted images. Gadolinium diethylenetriamine pentaacetic acid (GD-DTPA) was applied for image enhance-ment. Among the patients, 6 were with inflammation, 5 with undescending testes, 5 with ischemic testicles, 3 with intratesticular tumors, 1 with an extratesticular tumor, 3 with traumatic scrotums, 3 with varicoceles, and 1 each with hydrocele, hernia and vascular disease. Ultrasonic localiza-tion made 90% accuracy rate in diagnosis of scrotal diseases; however, MRI and dynamic en-hanced MR imaging provided 100% sensitivity, specificity and accuracy. MRI studies made it unnecessary to undergo diagnostic scrotal exploration in two cases (1 vascular disease, 1 acute epididymo-orchitis) and orchiectomy in three cases (2 epidermoid cysts and 1 simple cyst with hemorrhage). It also determined one case of extra-testicular tumor. The method clearly defined proper surgical plans for 5 cases of undescended testes. All pathologic scrota showed the great-est contrast in T2-weighted images. The studay demonstrated that dynamic enhanced MR imaging is powerful in case of ischemic testis and intratesticular lesions. (J Urol R.O.C., 9:111-116, 1998)