MR imaging of acute penile fracture

Penile fracture is a rare but serious urologic condition that typically req uires surgical repair. Because of its multiplanar capability and excellent tissue contrast, magnetic resonance (MR) imaging can be a useful diagnostic tool in the evaluation of patients with acute penile fracture. MR imaging can accurately depict the presence, location, and extent of tunical tear, w hich manifests as discontinuity of the tunica albuginea. Moreover, because the tunica albuginea is well demonstrated as a low-signal-intensity structu re on both T1- and T2-weighted images, MR imaging is optimal for the evalua tion of the integrity of this anatomic structure even in patients with seve re pain and swelling of the penis. This capability makes MR imaging particu larly helpful in determining the need for surgical intervention, which is l argely based on the integrity of the tunica albuginea. Associated injuries to adjacent structures (eg, corpus spongiosum, urethra) can also be demonst rated. In patients with no penile fracture, MR imaging can demonstrate an i ntact tunica albuginea and the presence of intracavernosal or extra-tunical hematoma. It remains uncertain whether the routine use of contrast materia l-enhanced MR imaging is justified, and further study is needed to determin e the role of this modality.