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MRI of penile fracture: what should be a tailored protocol in emergency?
Andrea Alessandro Esposito1, Caterina Giannitto2, Claudia Muzzupappa2
1Department of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Hospital, Via Francesco Sforza, 35, 20121, Milan, Italy. rxandreaesposito@yahoo.it.
Objectives:
To conduct a review of literature to summarize the existing MRI protocols for penile trauma, suggesting a tailored protocol to reduce costs and time of examination.
Materials And Methods:
A systematic search was performed in Medline, Embase, Cochrane Library, and Cinahl databases from 1995 to 2015 to identify studies evaluating penis trauma with MRI examination. Studies were included if there was the description of MRI protocol with at least sequences and orthogonal planes used. We chose a systematic approach for data extraction and descriptive synthesis.
Results:
12 articles were included in our study. Among the list of 12 articles: 2 were case reports, 3 were clinical series, and 7 were reviews. Clinical trials were not found. There is no unanimous consensus among the authors. Summarizing the data, the most used protocol is characterized by T2 sequences in three orthogonal planes plus T1 sequences in one plane (either axial or sagittal) without contrast medium injection.
Conclusion:
There is a lack of a standard protocol. A tailored protocol to answer the diagnostic question, reducing costs and time of examination, is characterized by T2 sequences in three orthogonal planes plus at least a T1 sequence (either axial or sagittal plane).
Insights
This review highlights the lack of a standard MRI protocol for penile trauma. A tailored protocol using T2 and T1 sequences in three orthogonal planes is suggested to improve efficiency and reduce costs.
Area of Science:
- Radiology
- Medical Imaging
- Urology
Background:
- Penile trauma diagnosis often relies on Magnetic Resonance Imaging (MRI).
- Existing MRI protocols for penile trauma lack standardization.
- There is a need for optimized MRI protocols to improve diagnostic efficiency and reduce healthcare costs.
Purpose of the Study:
- To review existing literature on MRI protocols for penile trauma.
- To identify common MRI sequences and planes used in penile trauma imaging.
- To propose a tailored MRI protocol for penile trauma to enhance cost-effectiveness and reduce examination time.
Main Methods:
- A systematic literature search was conducted across major databases (Medline, Embase, Cochrane Library, Cinahl) from 1995 to 2015.
- Studies describing MRI protocols for penile trauma, including sequences and orthogonal planes, were included.
- Data extraction and descriptive synthesis were employed to analyze the findings.
Main Results:
- Twelve articles met the inclusion criteria, comprising case reports, clinical series, and reviews; no clinical trials were found.
- A lack of consensus on a standard MRI protocol for penile trauma was observed.
- The most frequently reported protocol involved T2 sequences in three orthogonal planes and T1 sequences in one plane, without contrast.
Conclusions:
- A standardized MRI protocol for penile trauma is currently lacking.
- A proposed tailored protocol includes T2 sequences in three orthogonal planes and at least one T1 sequence (axial or sagittal).
- This optimized protocol aims to address diagnostic needs while reducing examination time and costs.
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