Abstract Archives of the RSNA, 2006
Usefulness of MRI in the Evaluation of Testis-sparing Surgery in Male Patients with Congenital Adrenal Hyperplasia and Testicular Adrenal Rest Tumors
Presented on November 28, 2006
Presented as part of SSG07: Genitourinary (Upper Tract MR)
Satoru Takahashi MD,PHD, Presenter: Nothing to Disclose
Hedi L Claahsen van der Grinten MD, Abstract Co-Author: Nothing to Disclose
Shuji Yamamoto PhD, Abstract Co-Author: Nothing to Disclose
Ad RMM Hermus MD,PhD, Abstract Co-Author: Nothing to Disclose
Barto J Otten MD,PhD, Abstract Co-Author: Nothing to Disclose
Jelle O. Barentsz MD, Abstract Co-Author: Nothing to Disclose
Yvonne Hoogeveen PhD, Abstract Co-Author: Nothing to Disclose
et al, Abstract Co-Author: Nothing to Disclose
To evaluate the usefulness of MRI in the assessment of bilateral testicular adrenal rest tumors (TART) and testicular volumes before and after operation in male patients with congenital adrenal hyperplasia (CAH) and TART who were treated with testis-sparing surgery.
Seven male CAH patients with TART (mean; 30 years, range; 23 to 51), who were treated with testis-sparing surgery, underwent testicular MRI before, 6 and 20 months after surgery at a 1.5-T MR unit (Magnetom Symphony or Sonata, Siemens) using a body phased-array coil. To compare the pre- and post-operative images, transverse T2-weighted TSE images (TR/TE=4,300~6,730 ms/ 109~135 ms) with a slice thickness of 2.5~4.0 mm were used. One experienced investigator measured the testicular volumes and the tumors using public domain software (ImageJ, a Java-based open source platform supported by NIH). The presence of residual tumor and the signal characteristics of the testes were visually assessed.
TART (mean; 8.3g, range; 0.5 to 22.9) were successfully enucleated in all patients without complications. No residual tumor was seen on postoperative MRI.
The measured volume of the tumors on preoperative MRI (mean: 9.6 mL, range: 0.5 to 30.3) showed a good correlation to the weight of surgical specimen (R2=0.81). In all patients the testes decreased in volume after the surgery (mean: -41%, range -4 to -81).
In 2 patients with large tumors 6 months after surgery in 4 testes (>10g), irregular low signal areas adjacent to the mediastinum testis were seen on T2-weighted TSE images, representing scar tissue, which decreased in size 20 months after the surgery.
MRI is useful for both preoperative assessment and postoperative follow-up of residual tumor and testicular volume in male CAH patients with testicular adrenal rest tumor treated with testis-sparing surgery.
MRI can accurately predict testicular tumor volume preoperatively.
MRI is useful to evaluate the volume of residual testicular tissue after testis-sparing surgery.
Claahsen van der Grinten, H,
et al, ,
Usefulness of MRI in the Evaluation of Testis-sparing Surgery in Male Patients with Congenital Adrenal Hyperplasia and Testicular Adrenal Rest Tumors. Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4439168.html