MR Imaging Technique of the Scrotum

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At our institution, a 1.5-T magnet is used for imaging the scrotum. The patient is placed supine on the table feet first. A folded towel is placed between the patient's thighs to elevate the scrotum to a horizontal plane. The penis is taped to the abdominal wall out of the area of interest. A 12.5-cm circular multipurpose surface coil is centered over the scrotum, with the bottom of the coil over the caudal tip of the scrotum. Axial and coronal T1- and T2-weighted images are acquired with a 16-cm field of view and a 4-mm section thickness. Additionally, axial fat-suppressed T1-weighted images are obtained. High-resolution dual-echo (in-phase and out-of-phase) axial T1-weighted spoiled gradient-echo sequences are also used to identify fat-water admixtures. These sequences also help to depict hemorrhage because hemosiderin will be most conspicuous on gradient-echo images because of T2* effects. Gadolinium-enhanced imaging is routinely performed at our institution after checking the patient's glomerular filtration rate, to avoid nephrogenic systemic fibrosis. Ideally, the unenhanced images should first be reviewed by a radiologist, and intravenous gadolinium-based contrast material should be administered only when indeterminate pathologic conditions are identified. Fat-suppressed, contrast-enhanced, three-dimensional (3D) T1-weighted fast spoiled gradient-recalled-echo (FSPGR) images are acquired in the axial and coronal planes. In addition, non–fat-suppressed contrast-enhanced FSPGR images are acquired in the sagittal plane.