الفهرس 
Embryology of the Male Genital OrgansOnly 14 pages are availabe for public view
 |  | from | 67 |  |  |
| | | from | 67 | | |
Abstract
Cryptorchidism is the absence of one or both testes in the scrotum The term ‘non-palpable testes’ implies that the testes cannot be detected on physical examination; they are intra-abdominal, absent, vanishing or atrophic.
Diagnostic imaging has been utilized to determine the anatomic location of non-palpable testes. Accurate pre-surgical localization of the testis could spare a child an operation in the setting of an absent testis or limit the extent of surgery if the testis can be definitively identified.
MRI is non-invasive imaging tool, does not involve ionizing radiation and yields multiplanar images but it is sometimes less efficient in locating intra-abdominal functioning testicles and it fails to locate most of the atrophied testicles.
Additional MRI assessments, as fat-suppressed T2WI and DWI are useful methods to improve the accuracy and sensitivity of diagnosis of non-palpable testes.
The aim of this study was to evaluate the diagnostic potential of combined DWI and conventional MRI examination of the abdomen and pelvis in localization of UDT.
We prospectively evaluated 30 patients ranging in age from 15 months to 15 years (mean = 6.4 ±3.9). 27cases were clinically and by US diagnosed having unilateral UDT (12 on the right side and 15 on the left side) and 3 cases having bilateral UDT.
MRI including T1WI, T2WI in addition to fat-suppressed T2WI sequence and diffusion-weighted images were performed to all patients. We compared the diagnostic performance of each MRI sequence for localization of UDT. MRI findings were interpreted by two radiologists with different levels of experience. The results of MRI were compared to laparoscopic findings.
According to the laparoscopic evaluation, the final diagnoses of the location of UDT were: intra-canalicular (n=10, 33.33%), low intra-abdominal (n=11, 36.66%), high intra-abdominal (n=2, 6.66%). Whereas the testes were absent (testicular agenesis) in 7 cases (23.33%) (regarding bilateral testes as one case).
We found that by adding DW images to the conventional MR images, both radiologists performed better in identifying the locations of the undescended testes. As combined DWI and conventional MRI had the highest accuracy (90%, 86.67%), sensitivity (86.96%, 82.61%); and specificity of (100%, 100%) for both observers respectively.