Deneysel testis torsiyonunda difüzyon ağırlıklı manyetik rezonans görüntülemenin yeri

Testicular torsion is a urologic emergency that causes ischemia in testicles due to twisting of spermatic cord and structures and requires early diagnosis and treatment. Delay in the diagnosis of testicular torsion causes loss of gonad and infertility. Color Doppler ultrasound (CDUS) is known as the method which provides the best result in the diagnosis testicular torsion. However, this technique is operator and device-dependent and has variable sensitivity. Diffusion weighted imaging (DWI) which measures the microscopic movements of water molecules, is a magnetic resonance imaging (MRI) sequence that does not require injection of contrast material. DWI has been shown to be successful in demonstrating the ischemia in rat testicles in the early period of testicular torsion. However, most patients attend to the hospital in late period and there is no systematic study examining the mid- and late period effects of ischemia in testicular torsion using DWI. Once the diagnosis of testicular torsion is made, the surgeon evaluates the detorsioned testicle intraoperatively for reperfusion. However, studies show that the testicles that could have been recovered were removed or testicles that had been irreversibly damaged were left after detorsion. The aim of this study is to evaluate the changes in mean ADC values according to degree and duration of torsion at 8th and 24th hours and to establish the role of DWI in testicular torsion. We also aim to show the relationship between the ADC values and testicular damage by comparing the ADC values in the 24th hour of torsion with histopathological findings and evaluate the salvability of torsioned testicles. Thirty-one male Wistar albino rats weighing 250-300 grams were used in the study. Rats were randomly selected and a total of four groups were formed; there were seven rats in the first group and eight rats in each of the other three groups. In group 1 (sham group) the testicle was kept outside for a minute and replaced. Left testicles were twisted 360 degrees in group 2, 720 ...