Positive Predictive Value of MRI in the Diagnosis of Intra-Abdominal Undescended Testes Taking Laparoscopic Findings as Gold Standard

Abstract

Background: Cryptorchidism also known as undescended testis, is a birth defect in male babies with higher frequency in preterm infants, leading infertility and other genital problems. In its treatment, diagnosis has a vital role. Objective: The objective of this study was to determine the positive predictive value of MRI in the diagnosis of intra-abdominal undescended testes taking laparoscopic findings as gold standard. Study Design:  It was a cross-sectional survey. Settings: Research was conducted at Department of Diagnostic Radiology, Children Hospital & Institute of Child Health Lahore Pakistan. Duration: Six months from June 23, 2018 to December 22, 2018. Methodology: This study involved 68 boys aged between 2 to 15 years presenting with undescended testes. Intra-abdominal undescended testes were diagnosed on MRI and was later confirmed on laparoscopic findings which were taken as gold standard and diagnosis of MRI was judged accordingly as true positive or false positive. A written informed consent was obtained from parents of every patient. Results: The age of the children ranged from 2 years to 15 years with a mean of 8.1±3.5 years. Majority (n=53, 77.9%) of the children had right while 15 (22.1%) children had left undescended testes. Diagnosis of intra-abdominal testes was confirmed in 64 (94.1%) patients on laparoscopy. Thus, there were 64 true positive and 4 false positive cases. It yielded a positive predictive value of 94.1% for MRI in predicting intra-abdominal undescended testes taking laparoscopy as gold standard. Similar positive predictive value was noted across various age and anatomical side groups. Conclusion: The positive predictive value of MRI was found to be 94.1% in predicting intra-abdominal undescended testes taking laparoscopic findings as gold standard regardless of patient’s age and anatomical side which along with its non-invasive and radiation free nature advocates its preferred use in future practice.