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[Computed tomography and magnetic resonance tomography in tuberculous spondylitis. A review of the literature and the authors' own observations].

PURPOSE: The findings of tuberculous spondylitis in MRT have been described extensively. Nevertheless the diagnostic value of both methods in the diagnosis of this severe manifestation of the tuberculous disease was not yet defined definitely. MATERIALS: We performed a review of the recent literature and a retrospective analysis of the findings in ten patients with proven tuberculous spondylitis. Here we evaluated 10 CT and 6 MRT. RESULTS: Major findings in computed tomography (n = 10) were osseous sequestration (8/10), subperiosteal bone apposition (6/10), abscess of the surrounding tissue. (8/10) and calcification of the masses (3/10). In all cases which were examined by MRT (n = 6) marrow edema was seen. Affection of the soft tissue was described by means of MRT in 5/6 patients. All patients showed rim enhancement. CONCLUSIONS: MRT shows signs of infection (bone marrow edema) which is an early but rather unspecific finding. The commonness of osseous lesions in advanced tuberculous spondylitis suggests a benefit of computed tomography in the later stages. Both methods are complementary in the differential diagnosis of tuberculous and non-specific spondylitis.

Adult↗

Comparison of 180 degrees and 360 degrees data acquisition for determination of left ventricular function from gated myocardial perfusion tomography and gated blood pool tomography.

The purpose of this study was to address the issue of 180 degrees versus 360 degrees data collection for left ventricular ejection fraction (LVEF) and left ventricular volume measurements using gated myocardial perfusion tomography (gMPT) and gated blood pool tomography (gBPT). Thirty patients with known coronary artery disease were injected in a random sequence with 925 MBq of technetium-99m tetrofosmin and, within 2 days, with 740 MBq of (99m)Tc-labelled human serum albumin. gMPT and gBPT were acquired using 360 degrees data collection and reconstructed by filtered backprojection using all the acquired projection images and separately using only projection images acquired from 45 degrees LPO to 45 degrees RAO. In order to have the same global count densities, the counts in the 360 degrees data set were redistributed using binomial deviates just before reconstruction. After reorientation along the left ventricular long axis, LVEF and left ventricular volumes were calculated using fully automatic algorithms. Twenty-eight patients also underwent planar radionuclide angiocardiography (PRNA) on the same day as the gBPT. For the gMPT studies, the correlation between 180 degrees data collection and 360 degrees data collection was excellent ( r>0.98). Bland-Altman analysis revealed small systematic and random differences (<6%) between 180 degrees and 360 degrees. For the gBPT studies, the correlation between 180 degrees data collection and 360 degrees data collection was very good ( r>0.93). However, Bland-Altman analysis revealed systematic differences of 26% and random differences of 17%. When PRNA was used as a reference, the best results were obtained with gMPT acquired using 180 degrees data, while the worst results were obtained with gBPT acquired using 180 degrees data. In conclusion, when evaluating LVEF and left ventricular volumes from gMPT, either 180 degrees or 360 degrees orbits can be used. However, 360 degrees data acquisition is recommended when evaluating LVEF and left ventricular volumes from gBPT.

Aged↗

Intraoperative ultrasonography versus helical computed tomography and computed tomography with arterioportography in diagnosing colorectal liver metastases: lesion-by-lesion analysis.

Helical computed tomography with arterioportography (CTAP) and intraoperative sonography (IOUS) are both recognized to be extremely sensitive in the detection of liver metastases measuring <2 cm in diameter. As sensitivity and specificity values for both techniques differ significantly in the literature and in default of sufficient published data regarding this subject, a lesion-by-lesion analysis was considered necessary. Accuracy of IOUS was compared with helical computed tomography (CT) and portal-phase contrast enhancement (CTAP) in the preoperative detection of liver metastases from colorectal carcinoma projected as a prospective blinded study. Cost efficiency should be determined. Liver CTAP and IOUS were evaluated in 33 patients with colorectal carcinoma. Metastases were resected in 10 cases, and the remaining 23 patients were observed for follow-up with CT investigations every 3 months for a period of 1 year. CTAP and IOUS detected all 13 lesions measuring 5-10 mm (13/13). One metastasis measuring >10 mm was missed by IOUS. CTAP presented an ideal sensitivity of 100%, but specificity was as low as 68%. IOUS sensitivity was 98% and specificity was 95%. IOUS and CTAP are of comparable value regarding the detection of liver metastases <10 mm. Both techniques may be used if resections of synchronous or metachronous metastases are planned in order not to miss limiting small lesions and to prevent superfluous liver surgery. Helical CT scan with dynamic intravenous contrast enhancement is considered the most cost-effective preoperative staging method, although local staging may not be achieved because of insufficient intraabdominal survey.

Adult↗

Assessment of coronary artery bypass graft patency by multidetector computed tomography and electron-beam tomography.

This case report describes the use of retrospectively ECG-gated 16-slice multidetector computed tomography (MDCT) and electron-beam tomography (EBT) for assessing bypass graft patency in two patients with recurrent angina after coronary artery bypass graft surgery. The results of each tomographic modality were compared to the findings of traditional coronary angiography. In the first patient MDCT showed occlusion of the left internal mammary artery (LIMA) and saphenous vein graft after the second anastomosis. Coronary angiography confirmed these findings. In the second patient EBT showed patency of the LIMA and saphenous vein graft. After the first anastomosis of the saphenous vein graft, the connected vessel filled poorly. Coronary angiography confirmed both grafts to be patent, and detected an occlusion distal to the first anastomosis. These findings support the evidence that both MDCT and EBT are suitable techniques for establishing bypass graft patency by non-invasive means.

Angina Pectoris↗

Comparison of positron emission tomography, computed tomography, and endoscopic ultrasound in the initial staging of patients with esophageal cancer.

INTRODUCTION: Improvement in esophageal cancer staging is needed. Positron emission tomography (PET), computed tomography (CT), and endoscopic ultrasound (EUS) in the staging of esophageal carcinoma were compared. METHODS: PET, CT, and EUS were performed and interpreted prospectively in 75 patients with newly diagnosed esophageal cancer. Either tissue confirmation or fine needle aspiration (FNA) was used as the gold standard of disease. Sensitivity and specificity for tumor, nodal, and metastatic (TNM) disease for each test were determined. TNM categorizations from each test were used to assign patients to subgroups corresponding to the three treatment plans that patients could theoretically receive, and these were then compared. RESULTS: Local tumor staging (T) was done correctly by CT and PET in 42% and by EUS in 71% of patients (P value > 0.14). The sensitivity and specificity for nodal involvement (N) by modality were 84% and 67% for CT, 86% and 67% for EUS, and 82% and 60% for PET (P value > 0.38). The sensitivity and specificity for distant metastasis were 81% and 82% for CT, 73% and 86% for EUS, and 81% and 91% for PET (P value > 0.25). Treatment assignment was done correctly by CT in 65%, by EUS in 75%, and by PET in 70% of patients (P value > 0.34). CONCLUSIONS: EUS had superior T staging ability over PET and CT in our study group. The tests showed similar performance in nodal staging and there was a trend toward improved distant disease staging with CT or PET over EUS. Assignment to treatment groups in relation to TNM staging tended to be better by EUS. Each test contributed unique patient staging information on an individual basis.

Endosonography↗

Iodine-123 phenylpentadecanoic acid and single photon emission computed tomography in identifying left ventricular regional metabolic abnormalities in patients with coronary heart disease: comparison with thallium-201 myocardial tomography.

Iodine-123 phenylpentadecanoic acid (IPPA) is a synthetic long chain fatty acid with myocardial kinetics similar to palmitate. Two hypotheses were tested in this study. The first hypothesis was that IPPA imaging with single photon emission computed tomography (SPECT) is useful in the identification of patients with coronary artery disease. Fourteen normal volunteers (aged 27 +/- 2 years) and 33 patients (aged 54 +/- 11 years) with stable symptomatic coronary artery disease and at least one major coronary artery with luminal diameter narrowing greater than or equal to 70% were studied with symptom-limited maximal exercise testing. The IPPA (6 to 8 mCi) was injected 1 min before the termination of exercise, and tomographic imaging was performed beginning at 9 min and repeated at 40 min after the injection of IPPA. Nine of the normal volunteers and 13 of the patients had a second examination performed at rest on another day. Using the limits of normal as 2 SD from the normal mean values, 27 of the 33 patients with coronary artery disease demonstrated abnormalities in either the initial distribution or the clearance of IPPA, or both. Nineteen of the 33 patients had a maximal variation of activity distribution of greater than or equal to 25% on the 9 min IPPA images. Twenty-two of the 33 patients had a maximal variation in IPPA washout greater than 17% and 17 had a washout rate less than or equal to 2%. There was good agreement between the location of significant coronary artery stenoses and abnormalities in the initial distribution and clearance of IPPA. The second hypothesis tested was that IPPA imaging is as or more sensitive and, therefore, complementary to thallium-201 imaging in the identification of exercise-induced ischemia in patients. Twenty-five of the 33 patients underwent both thallium-201 and IPPA tomographic imaging after symptom-limited maximal exercise testing. The amount of exercise performed by each patient during both studies was similar. Twenty-one of the 25 patients had abnormal IPPA tomographic studies, whereas 18 had abnormal thallium-201 tomographic studies (p = NS). The results of this study suggest the following conclusions: 1) iodine-123 phenylpentadecanoic acid imaging using single photon emission computed tomography and exercise provides a sensitive and relatively noninvasive method for identifying abnormalities in myocardial metabolism associated with significant coronary artery stenoses, and 2) iodine-123 phenylpentadecanoic acid is at least as sensitive as thallium-201 for this purpose using tomographic imaging and exercise testing.

Adult↗

Optical coherence tomography and confocal scanning laser tomography for assessment of macular edema.

PURPOSE: To compare optical coherence tomography (OCT) and confocal scanning laser tomography (cSLT) for quantitative retinal thickness mapping of the macula and their ability to detect macular edema. DESIGN: Prospective, comparative, clinical observational study. METHODS: The study population of 138 eyes (97 patients) was divided into a study group consisting of 45 (32.6%) eyes with macular edema and a control group consisting of 93 (67.4%) eyes without macular edema. All patients underwent OCT and cSLT of the macula. Retinal thickness measurements obtained by OCT were compared with signal width and edema index, determined by cSLT. RESULTS: The OCT measurements and cSLT edema index were significantly (P <.001) correlated with each other. Correlation coefficients decreased (P <.001) with increasing diameter of the measurement circle. In the macular edema group, correlation coefficients were significantly (P <.001) higher than in the control group. To separate the study and control groups, receiver operator characteristic curves covered a larger area for OCT measurements than for cSLT measurements. Retinal thickness measurements and edema index correlate with visual acuity (correlation coefficient r = -.653 for OCT, r = -.608 for cSLT; P <.001). CONCLUSIONS: Macular edema can be quantitatively mapped by OCT and cSLT. The retinal thickness and edema index measurements correlate with visual acuity. The fast and standard examination modes of OCT give similar measurements. Both OCT and cSLT can differentiate between eyes with and without macular edema, with OCT showing a higher predictive value.

Aged↗

A study of trabecular bones in ovariectomized goats with micro-computed tomography and peripheral quantitative computed tomography.

Osteoporotic fractures occur most frequently in trabeculae-rich skeletal sites. The purpose of this study was to use a high-resolution micro-computed tomography (micro-CT) to investigate the changes in trabecular bone microarchitecture and to use a peripheral quantitative computed tomography (pQCT) to study changes in volumetric bone mineral density (BMD) in a large animal model resulted from ovariectomy (OVX). Ten adult goats were used for this study. The first iliac crest biopsy was harvested before OVX and served as baseline; the second biopsy was collected 6 months later from the opposite side for both pQCT and micro-CT measurements. Results showed that after 6 months of OVX, the BMD of the iliac crest biopsies decreased significantly by 16.3% (P < 0.05). The bone volume density (BV/TV), trabecular number (Tb.N), and connectivity density (Conn.D) measured with micro-CT decrease significantly after OVX, with an average decrease of 8.34%, 8.51%, and 18.52% (P < 0.05 each), respectively. The trabecular plate separation (Tb.Sp) was 8.26% (P < 0.05) greater than baseline after OVX. Significant correlations were found between the reduction of BMD and the decreases of BV/TV and Tb.N (r = 0.839 and 0.719, respectively; P< 0.001 both), as well as the increase of Tb.Sp (r = -0.758, P< 0.001) and SMI (r = -0.697, P< 0.001). In conclusion, this was the first experimental study in goat model to show that OVX-induced bone loss in goats was attributed by deterioration of trabecular microarchitecture.

Animals↗

Postoperative residual tumour imaged by contrast-enhanced computed tomography and 201Tl single photon emission tomography: can they predict progression-free survival in high-grade gliomas?

AIMS: To evaluate if postoperative residual tumour imaged by either computed tomography or 201Tl single photon emission tomography (SPECT) carried out postoperatively could predict progression-free survival (PFS) in high-grade malignant gliomas. MATERIALS AND METHODS: Thirty-three patients with high-grade malignant gliomas underwent both contrast-enhanced CT scan and 201Tl-SPECT postoperatively before receiving radiotherapy. The PFS was evaluated against the individual reports of the above two imaging studies by univariate analysis. RESULTS: CT and 201Tl-SPECT were carried out within a median interval of 17 days after surgery. Of the 33 patients, CT and 201Tl-SPECT were reported as positive for residual tumours in 23 (69.7%) and 30 (91%) patients, respectively. Sensitivity, specificity and overall accuracy were 71.4%, 40% and 66.6% for CT, and 96.4%, 40% and 87.8% for 201Tl-SPECT, respectively, and were based on their last follow-up status (P = 0.627 for CT; P = 0.053 for 201Tl-SPECT). The median PFS for patients reported to be positive or negative on CT scan was 4 and 5 months, respectively (P = 0.202). With 201Tl-SPECT, although the median PFS for patients with a positive 201Tl uptake was also 4 months, it had not even reached for those reported having a negative 201Tl uptake (cumulative survival 66.7% at last follow-up) (P = 0.198). However, Karnofsky performance status (KPS) was the only significant predictor on univariate analysis (KPS: < 80 vs. > or = 80; P < 0.001) for PFS. CONCLUSIONS: Although both the imaging modalities have a poor specificity, postoperative 201Tl-SPECT had a significantly better accuracy to predict the status at last follow-up than contrast-enhanced CT. Nevertheless, KPS remained the most significant outcome predictor for PFS in high-grade malignant gliomas.

Adult↗

Influence of heart rate on the detectability and reproducibility of multislice computed tomography for measuring coronary calcium score using a pulsating calcified mock-vessel in comparison with electron beam tomography.

BACKGROUND: The influence of heart rate on detectability and reproducibility of multislice computed tomography (MSCT) for measuring coronary calcium score was evaluated using pulsating calcified mock-vessels and compared with electron beam tomography (EBT). MATERIALS AND METHODS: Four calcified mock-vessels with 200-350 HU were made to pulsate at a rate of 40-80 beat/min. Retrospective ECG-gating MSCT (Light Speed Ultra 16) scanning with 0.625 mm slice-thickness was performed twice at each pulsation rate. For comparison, EBT (Imatron C150 XP) was performed with 3 and 1.5 mm beam collimation with prospective ECG-gating and calcium scores were measured. RESULTS: The comparison revealed that MSCT did not have better reproducibility than EBT, but the calcium scores with MSCT were less influenced by pulsation rates than those with EBT. Especially in mild calcification, the calcium scores decreased with EBT with 3 mm beam collimation with increasing pulsation rate, but the scores were stable in any rate with MSCT. CONCLUSION: MSCT effectively detects coronary calcification, especially mild calcification, without being influenced by heart rate. This is accomplished by reducing the partial volume effect in the through plane using sub millimeter slice thickness, and using appropriate reconstruction methods, which improve temporal resolution.

Calcinosis↗

What imaging studies are necessary for abdominal aortic endograft sizing? A prospective blinded study using conventional computed tomography, aortography, and three-dimensional computed tomography.

OBJECTIVE: Preoperative imaging modalities for endovascular abdominal aortic aneurysm repair (EVAR) include conventional computed tomography (CT), aortography with a marking catheter, and three-dimensional computed tomography (3D CT). Although each technique has advantages, to date no study has compared in a prospective manner the reproducibility of measurements and impact on graft selection of all three modalities. The objective of this study was to determine the most useful imaging studies in planning EVAR. METHODS: Twenty patients being considered for EVAR were enrolled prospectively to undergo a conventional CT scan and aortography. The CT scans were then reconstructed into 3D images using Preview Treatment Planning Software (Medical Media Systems, West Lebanon, NH). Four measurements of diameter and six of length were made from each modality in determining the proper graft for EVAR. RESULTS: Measurements from all three modalities were reproducible with intraobserver correlation coefficients of 0.79 to 1.0 for aortography, 0.87 to 1.0 for CT, and 0.96 to 1.0 for 3D CT. Measurements between observers were also similar from each modality; interobserver correlations were 0.70 to 0.97 for aortography, 0.76 to 0.97 for CT, and 0.73 to 0.99 for 3D CT. Significant differences ( P < .01) in diameter measurements were noted at D2 with aortography compared with 3D CT, whereas differences in length measurements were found between CT and 3D CT at L4 (nonaneurysmal right iliac) ( P < .01). The correlation between CT and 3D CT for most length measurements was acceptable (0.63 to 1.0). Aortography for diameters correlated poorly (0.35 to 0.67) with 3D CT. When the endograft selected by aortography/CT or 3D CT alone was compared with the actual endograft used, there was agreement in 11 of 11 patients when adjusted for +/- one size in diameter or length. CONCLUSION: Reproducible and comparable measures of diameter and length can be obtained by each of three imaging modalities available for endograft sizing. As a single imaging modality, 3D CT appears to have the best correlation for both diameters and lengths; however, the difference is not sufficient enough to alter endograft selection. Three-dimensional CT may be reserved for challenging aortic anatomy where small differences in measurements would affect patient or graft selection for EVAR.

Aged↗

Application of convergent-beam collimation and simultaneous transmission emission tomography to cardiac single-photon emission computed tomography.

Single-photon emission computed tomography (SPECT) is the most commonly performed imaging technique for perfusion studies of the heart and brain. However, these organs are much smaller than the crystal surface of gamma cameras. SPECT sensitivity and resolution can be improved by using fan- and cone-beam collimators to magnify the image of these organs over a larger portion of the crystal face. Special orbits and reconstruction algorithms must be used with convergent-beam acquisitions to prevent image distortion. Differential attenuation of source activity in the chest is one of the most vexing problems in cardiac SPECT, especially with Thallium-201. Multi-headed cameras equipped with convergent-beam collimators allow a transmission image to be obtained at the same time as emission images. Applying a transmission map of the chest attenuation values to the emission images produces a truer picture of source distribution in the heart. This article reviews the technical problems associated with convergent-beam geometry and simultaneous transmission emission tomography SPECT imaging of the heart.

Algorithms↗

Noninvasive coronary angiography by magnetic resonance imaging, electron-beam computed tomography, and multislice computed tomography.

In recent years, several techniques for noninvasive imaging of the coronary artery lumen (noninvasive coronary angiography) have been developed. These techniques include magnetic resonance imaging, electron-beam computed tomography, and, most recently, multislice computed tomography. Each of these techniques has specific advantages and disadvantages. Currently, EBCT seems to permit the most robust coronary artery imaging. In the future, imaging modalities will have to be further improved and validated in order to define specific areas for potential clinical applications.

Clinical Trials as Topic↗

Cortical blindness in severe preeclampsia: computed tomography, magnetic resonance imaging, and single-photon-emission computed tomography findings.

BACKGROUND: Cortical blindness is a complication of severe preeclampsia, but it is unclear whether it results from cerebral vasospasm and ischemic injury or vasogenic (hydrostatic) edema due to increased capillary permeability. CASE: Reversible cortical blindness in a 33-year-old gravida 2, para 1, with severe postpartum preeclampsia after evacuation of a partial molar pregnancy at 19 weeks' gestation is presented. Initial neuroimaging studies showed hyperperfusion on head single-photon-emission computed tomography scan, which corresponded with lesions found on head computed tomography and magnetic resonance imaging scans. Follow-up neuroimaging studies 2 weeks later, by which time the patient's visual acuity had returned to normal, showed complete resolution of radiologic abnormalities. CONCLUSION: Neuroimaging studies in a woman with severe postpartum preeclampsia complicated by reversible cortical blindness showed that blindness resulted from vasogenic (hydrostatic) cerebral edema and not cerebral vasospasm.

Adult↗

Heidelberg retina tomography and optical coherence tomography in normal, ocular-hypertensive, and glaucomatous eyes.

PURPOSE: To evaluate optic disc and retinal nerve fiber layer (RNFL) appearance in normal, ocular-hypertensive, and glaucomatous eyes undergoing confocal scanning laser ophthalmoscopy and optical coherence tomography (OCT). DESIGN: Prospective, cross-sectional study. PARTICIPANTS: Seventy-eight eyes of 78 consecutive normal (n = 17), ocular-hypertensive (n = 23), and glaucomatous subjects (n = 38) were enrolled. METHODS: Each patient underwent complete ophthalmic examination, achromatic automated perimetry, confocal scanning laser ophthalmoscopy (Heidelberg Retinal Tomography [HRT]), and OCT. Topographic HRT parameters (disc area, cup-disc ratio, rim area, rim volume, cup shape measure, mean RNFL thickness, and cross-sectional area) and mean OCT-generated RNFL thickness were evaluated in each group. MAIN OUTCOME MEASURES: OCT and HRT assessment of optic disc and RNFL anatomy. RESULTS: OCT RNFL thickness showed no difference between normal and ocular-hypertensive eyes (P = 0.15) but was significantly less in glaucomatous eyes (P < 0.001). HRT measurements of rim area, cup-disc ratio, cup shape measure, RNFL thickness, and RNFL cross-sectional area were significantly less in glaucomatous eyes (all P < 0.005) and were correlated with mean OCT RNFL thickness (all P < 0.02). RNFL thickness using OCT or HRT was highly correlated with visual field mean defect during achromatic perimetry (P < 0.0001). CONCLUSION: Both HRT and OCT can differentiate glaucomatous from nonglaucomatous eyes. RNFL thickness measurements using OCT correspond to disc topographic parameters using HRT.

Adult↗

Comparability of three-dimensional optic disc imaging with different techniques. A study with confocal scanning laser tomography and raster tomography.

PURPOSE: We wanted to compare optic nerve head topography measurements and discrimination between normal and glaucomatous eyes with two entirely different three-dimensional optic disc imaging techniques, confocal scanning laser tomography (Heidelberg Retina Tomograph, Heidelberg Engineering) and raster tomography (Glaucoma-Scope, Ophthalmic Imaging Systems). METHODS: Both eyes of 225 normal subjects and 229 eyes of 166 patients with glaucoma at different stages were imaged with the Heidelberg Retina Tomograph and the Glaucoma-Scope. Optics discs were analysed in 15 degrees sectors around the circumference. Depth measurements were calibrated on objects with known dimensions. RESULTS: We observed no significant differences in absolute measurements of maximum cup depth and cup area between the two instruments. We observed small differences in absolute measurements of disc anti rim area between the two instruments. Discrimination between normal and glaucomatous eyes was close to identical for the two instruments. Both instruments had the same ability to distinguish glaucomatous regional alterations of optic nerve head topography from normal disc configuration. CONCLUSION: Both instruments while using entirely different principles for three-dimensional optic disc imaging gave very similar results. This correspondence of results implies that the same optic disc parameters can be analysed, and the results interpreted similarly for both methods, and probably with other three-dimensional imaging instruments. It may also indicate that results of studies with one of the instruments have general validity.

Adult↗

Comparison of single-photon emission computed tomography with [123I]iodoamphetamine and xenon-enhanced computed tomography for assessing regional cerebral blood flow.

Regional CBF (rCBF) images obtained from xenon-enhanced computed tomography (XeCT) and single-photon emission computed tomography (SPECT) with N-isopropyl-p-[123I]iodoamphetamine (IMP) done with a rotating gamma-camera were compared in nine patients. Both XeCT and SPECT/IMP demonstrated flow abnormalities at all sites of infarction identified by CT, while detecting reduced rCBF in areas normal by CT in eight of the nine patients. All areas that were abnormal on XeCT were abnormal on the comparable SPECT/IMP images. The major advantages of XeCT are its greater resolution and potential for noninvasive quantitation of rCBF, while the major advantage of SPECT/IMP is its visualization of the entire brain on transverse, coronal, and sagittal sections.

Amphetamines↗

[Magnetic resonance tomography in the differential diagnosis of pathologic changes in scrotal contents--a comparison with computed tomography].

48 patients with scrotal pathology were examined by magnetic resonance tomography (MRI) and computed tomography (CT). The diagnostic results were compared to surgical and histological findings. The correct diagnosis could be detected in 81% by CT and in 85% by MR. Another 27 patients were examined only by MR with positive results in 88%. Demonstration of tunica albuginea, imaging of testes in various planes and diagnostic accuracy in about 88% with missing ionising irradiation make MRI the most reliable diagnostic imaging in the classification of scrotal pathology. False negative results were found in 1/48 by CT and none by MRI. False positive results could be found in 2/75 of MRI examinations but none in CT.

Abscess↗