Gadolinium-enhanced T1-weighted versus T2-weighted imaging of scrotal disorders: is there an indication for MR imaging?

To evaluate the use of gadopentetate dimeglumine in magnetic resonance (MR) imaging of scrotal disorders, the clinical, ultrasound, and MR imaging data of 29 patients (age range, 19-75 years) with various intra- and extratesticular disorders were retrospectively analyzed. T1- and T2-weighted spin-echo images (T1-T2 group) were compared with T1-weighted spin-echo images before and after intravenous administration of gadopentetate dimeglumine (T1-Gd group). A receiver operating characteristic (ROC) analysis of the findings was undertaken. Better contrast between tumor and parenchyma and a clearer demonstration of the tunica albuginea were noted in the T1-T2 group (although not of diagnostic relevance). ROC analysis revealed no differences between the two imaging groups in the diagnosis of tumor, trauma, hydrocele, or hemorrhage; however, epididymitis was diagnosed more easily with contrast enhancement (0.8834 vs 0.7759, P = .04) and the diagnosis of orchitis was expressed more strongly (0.8221 vs 0.7184, P = .17). Four of the five observers were more confident in making the diagnosis with contrast enhancement. With MR imaging, the diagnosis was correctly suggested in three patients in whom clinical and ultrasound data were inconclusive. Gadolinium-enhanced MR imaging gives additional information in scrotal disorders and facilitates diagnosis. It may be helpful when findings at physical examination and ultrasound differ and when plain T1- and T2-weighted images are equivocal.