GADOLINIUM-INFUSION MAGNETIC-RESONANCE ANGIOGRAM - A NEW, NONINVASIVE, AND ACCURATE METHOD OF PREOPERATIVE LOCALIZATION OF IMPALPABLE UNDESCENDED TESTES

Purpose: This study investigates the usefulness of Gadolinium (Gd)-inf usion magnetic resonance angiogram (MRA) in the detection of impalpabl e undescended testes. Methods: Magnetic resonance (MRI) examination wa s performed in 14 patients with 17 impalpable undescended testes (Unil ateral, n = 11; bilateral, n = 3). MRA was then performed as follows: Gadolinium-DTPA-BMA (Omniscan) at 0.3 mmol/kg body weight was injected intravenously, and dynamic coronal examination using fast spoiled gra dient recalled sequences was obtained with images taken at early arter ial and delay venous phases. The testis was located by detection of th e enhanced pampiniform venous plexus. Results: Of the 17 undescended t estes, 11 canalicular hypoplastic testes and 3 intraabdominal testes w ere detected in both routine MRI and MRA. Three atrophic testes were f ound in the scrotum by MRA but not detected by routine MRI. The detect ion rates of impalpable testes by MRI and MRA were 82.4% and 100%, res pectively. AII imaging findings were confirmed by surgical exploration . There was no morbidity associated with MRA. Conclusion: Gd-infusion MRA is an accurate and sensitive method of preoperative localization o f impalpable testes and is superior to conventional MRI in the detecti on of atrophic testes. Copyright (C) 1998 by W.B. Saunders Company.