DYNAMIC MRI OF BENIGN AND MALIGNANT TESTICULAR LESIONS - PRELIMINARY-OBSERVATIONS

Sonography and color-coded Doppler sonography are the methods of first choice in diagnosing pathological changes of the testes. The MRI tech nique was tested using a dynamic technic to evaluate the possibility o f differentiating between benign and malignant testicular lesions. The testes of 20 volunteers and of 15 patients were examined in a field s trength of 1.5 Tesla (Philips Gyroscan S15) with a multislice T1-weigh ted fast field echo (FFE) sequence before and every minute after the i njection of 0.1 mmol/kg Gd-DTPA. The histopathological evaluation afte r the MRI examination revealed five seminomas, three mixed tumors, one teratocarcinoma, one embryonal carcinoma, one Sertoli tumor, two derm oid cysts, one chronic epididymitis/fibrosis and one necrosis/atrophy. In malignant lesions the maximum increase of signal intensity (SI) af ter injecting contrast medium was significantly higher (p < 0.001) com pared with normal testes, whereas benign lesions showed a lower or sim ilar maximum relative signal change compared with the volunteer group. If these early observations can be confirmed in a large number of pat ients, dynamic MRI seems to be able to differentiate between benign an d malignant testicular lesions. Dynamic MRI might become an additional tool with high diagnostic accuracy that is independent of the examine r.