Preoperative magnetic resonance imaging in the management of the nonpalpable testis
| Autor: | Kamigaito, Takayuki, Nishizawa, Shuji, Nakayama, Tsuyoshi, Okaneya, Toshikazu, Suzuki, Kazumi, Morita, Tatsuo |
|---|---|
| Jazyk: | japonština |
| Rok vydání: | 2008 |
| Předmět: | |
| Zdroj: | 泌尿器科紀要. 54(2):107-109 |
| ISSN: | 0018-1994 |
| Popis: | 1997～2005年に停留精巣で診療した男児99症例, 成人7例のうち, 41例(初診時年齢中央値3歳6ヵ月)の非触知精巣例にMRIを施行した。その結果, 1)片側性が40例, 両側性が1例で, MRIで18例19精巣が鼠径部に指摘された。2)同部切開で検索したところ, 18精巣は鼠径管以下の, 1精巣は腹腔内の存在が確認され, 全て通常の精巣固定術で陰嚢内に固定された。3)6例6精巣は腹腔内精巣と画像診断され, 腹腔鏡で5例が腹腔内精巣と確認された。擬陽性は25例中1例で, 7例17精巣はMRIで精巣を見出せなかった。5)16例は腹腔鏡, 1例は鼠径部切開で検索し, 4例の腹腔内精巣が確認された。11例は精巣血管と精管が内鼠径輪へ進入しており, 鼠径部切開で検索したが精索, 精管, 小塊のみであった。2例では精巣血管, 精管が内鼠径輪頭側で消失し, 擬陽性は17例中4例であった。6)精巣の存在について, MRI検査の感度は85.7%, 特異度は92.9%であった。リンパ節を精巣と誤認することが擬陽性の原因であった。 We evaluated the efficacy of magnetic resonance imaging (MRI) as the preoperative study in the management of the nonpalpable testis. From 1997 to 2005, a total of 41 MRI was performed for the patients with nonpalpable testis and 42 testes were evaluated. The MRI showed 19 testes from 18 patients in the inguinal region. Eighteen testes were found in the inguinal region and one was intraabdominal during groin exploration. Six testes were pointed out to be intra-abdominal by MRI. Five testes were identified in the abdomen and one was disclosed to be vanishing testis. Seventeen testes could not be detected by MRI and they underwent laparoscopic or groin exploration. Four abdominal testes were identified. Thirteen patients had a diagnosis of vanishing testis. The sensitivity and the specificity of our MRI studies in predicting the presence of nonpalpable testis were 85.7% and 92.9%, respectively. Enlarged lymph node could be misdiagnosed as abdominal testis. Inguinal undescended testes can be diagnosed accurately with MRI. MRI is informative regarding the testis location and useful for limiting the area of surgical exploration. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|