Adult UrologysInconclusive Clinical and Ultrasound Evaluation of the Scrotum: Impact of Magnetic Resonance Imaging on Patient Management and Cost
Section snippets
Subjects
We retrospectively reviewed the clinical and radiologic records of 34 patients who underwent sequential and contemporaneous scrotal US and scrotal MRI from 1992 to 1996 at three medical centers. In all cases, US was performed prior to MRI. The mean age of the 34 patients was 40 years (range 11 to 72). Final diagnoses were established by surgery (n = 18) or clinical and US follow-up (n = 16). In the latter 16 patients, the mean duration of follow-up was 14 months (range 6 to 48). All 34 patients
Results
Billing records indicated that 2358 scrotal US examinations were performed at the three institutions over the study interval. Of these patients, 34 underwent subsequent contemporaneous scrotal MRI. The incidence of inconclusive clinical and US evaluation of the scrotum is, therefore, 1.4% (34 of 2358). Clinical and US evaluations of the scrotum were inconclusive in the 34 patients undergoing scrotal MRI because of discordant clinical and US findings (n = 21), wide differential diagnosis after
Comment
The cost effectiveness of innovative imaging technology such as MRI is largely unknown. The purpose of this study was to assess the diagnostic utility and net cost of MRI in cases of inconclusive clinical and US evaluation of scrotal lesions. The frequency of inconclusive clinical and US evaluation in this study was 1.4%. Implicit in this analysis was that the request for MRI indicated inconclusive clinical evaluation, even in conjunction with US. This low frequency of inconclusive clinical and
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