Testicular MRI

If you’re experiencing persistent pain, swelling or tenderness in your scrotum, or if you’ve had an injury to the area, a testicular MRI (magnetic resonance imaging) can provide the answers you need to get the best treatment. Our guide has everything you need, from what a testicular MRI can diagnose to how the procedure works. Plus, we have information on how to get a scan and what you can expect on the day. 

What is a Testicular MRI?

A testicular MRI is a detailed imaging scan that uses strong magnets and radio waves to create high-quality images of the testicles, epididymis, spermatic cord, rete testis, tunica albuginea, and tunica vaginalis - all crucial parts of the male reproductive system.

Reasons for a Testicular MRI

Your doctor may recommend a testicular MRI if one of the following applies to you:

• You are experiencing persistent pain, tenderness or swelling in the scrotum.

• You have a lump that needs further investigation.

• You have unexplained pelvic or lower back pain.

• You have a feeling of heaviness in the scrotum.

• You have unexplained problems with urination.

• You’ve had an injury to the scrotum.

• One of your testicles is a different size or shape from the other.

• Your doctor suspects you may have testicular cancer.

• You have a medical emergency, such as a twisted scrotum (testicular torsion).

• You are experiencing symptoms of an infection, such as pain, swelling, redness, discharge, or warmth in the scrotum.

• You have an elevated PSA level (prostate-specific antigen), which needs further investigation.

While ultrasound is the primary scanning technique your medical specialists will use to get high-resolution images of the scrotum, a testicular MRI can be beneficial when ultrasounds don’t give clear answers or when your doctor needs more information about any unusual growths, injuries or infections. If you have a testicular mass or your doctor suspects a testicular neoplasm, such as testicular seminoma or other germ cell tumours like embryonal carcinoma, an MRI can support your diagnosis and treatment plan.

Types of Testicular MRI Scan

There are several types of MRI scans for the testicles available. Each one is designed to enhance particular aspects of the soft tissues in the scrotal area. 

Standard MRI Without Contrast

This technique uses T1- and T2-weighted sequences to provide detailed anatomical images of the scrotum and testicles. T1- and T2-weighted images help distinguish between normal tissue, fibrosis, or signs of segmental testicular infarction.

MRI With Contrast (Gadolinium Administration)

This scan uses a special dye called gadolinium to enhance visibility of testicular cancer and helps identify pathologic conditions that may need removal of one or both testicles (orchiectomy) or testis-sparing surgery. 

Your technologist will inject the dye into your bloodstream via a small needle in your arm. The contrast dye highlights areas with increased blood flow and can help your doctor spot any inflammation.

Diffusion-Weighted Imaging (DWI)

This technique looks at how water moves through tissues. Changes to usual movement can be an indication of tumours, damaged tissue or inflammation. It’s especially useful when sonographic findings are unclear and a differential diagnosis may be needed.

Dynamic Contrast-Enhanced MRI (DCE-MRI)

This scan also uses contrast dye but takes a series of images over time to track how blood flows through the testicles. It helps detect tumours and identify issues like torsion, where blood flow is reduced. 

What a Testicular MRI Can Diagnose

An MRI scan of the testicles can help diagnose many different conditions because it gives a clear, detailed image of soft tissues from multiple angles, which helps your doctor make an accurate diagnosis. If your doctor suspects testicular cancer, an MRI can show whether a lump is cancerous or something harmless, such as a fluid-filled cyst. It also helps your doctor plan surgery if you need it. 

In cases of testicular torsion (where the testicles are twisted), MRI can show signs of bleeding or reduced blood flow, key signs that urgent treatment is needed. 

It’s also good at spotting infections, such as epididymitis or orchitis, collections of fluid, swollen veins, injuries, abscesses or even hernias that extend into the scrotum. 

• Testicular cancer: helps tell if a lump is cancerous or not, and supports planning for surgery.

• Testicular torsion: can show if a testicle has twisted and lost its blood supply—this is a medical emergency.

• Epididymitis: can detect swelling and inflammation in the epididymis (a tube behind the testicle), often caused by infection.

• Orchitis: can show inflammation of the testicle itself, which might be due to infection or a virus.

• Varicocele: helps identify enlarged veins in the scrotum, which can cause pain or affect fertility.

• Hydrocele: shows fluid build-up around the testicle, usually a harmless condition.

• Spermatocele: can confirm the presence of a fluid-filled sac in the epididymis, which is usually not cancerous.

• Scrotal trauma: helps assess damage after injury, such as bruising, bleeding, or tearing of tissues.

• Testicular abscess: can spot a pocket of pus inside the testicle, often due to a severe infection.

• Inguinal hernia: can show if part of the intestine or other tissue has pushed down into the scrotum through a weakness in the groin area.

How a Testicular MRI Works

A testicular MRI uses a powerful magnet and radio waves to take detailed images of your testicles and surrounding tissues. It works by lining up tiny water particles in your body using a magnetic field. Radio waves then move them out of place. As the water particles return to normal, they send out signals that the MRI scanner uses to build images. If your radiologist uses a contrast dye, it helps show blood flow in the area, making it easier to distinguish between healthy and diseased tissue.

Benefits

There are plenty of benefits to having a testicular MRI, including:

• No needles or surgical procedures are required, unless you are having contrast dye.

• It has no harmful ionising radiation, unlike X-rays or CT scans.

• It produces clearer images of soft tissues than ultrasound or CT.

• It helps your doctor accurately diagnose problems and plan treatment.

Risks & Side Effects

Testicular MRI is generally very safe for most people, but some may feel:

• Claustrophobic when in the scanner.

• Minor side effects if contrast dye is used, such as nausea, or, more rarely, an allergic reaction.

People with kidney problems may need extra checks before having contrast dye.

How to Prepare for a Testicular MRI

There is no particular preparation you need to do before your testicular MRI. However, if you are having a contrast dye, you may be asked to avoid eating or drinking in the hours leading up to the scan.

The Procedure Explained: What to Expect

When you come in for your testicular MRI, your radiologist will ask you to change into a hospital gown and remove any metal, including jewellery, watches, and belts. They may warn you that the scan can be a bit uncomfortable and noisy, and they may offer you earplugs or headphones to use.

During the scan, your technologist will ask you to lie on a sliding table that will move slowly into the scanner. Your scrotum will be carefully positioned and stabilised for precise imaging. If contrast is needed, this will be injected into your arm through a small needle. 

The scan itself takes around 30 to 60 minutes, and you should be able to go home straight after, with no recovery time needed. 

How Does it Feel?

While the MRI scan itself is painless, it can be uncomfortable or claustrophobic for people who don't like small spaces. Your radiologist will do everything possible to help you feel more comfortable, sometimes offering sedation if needed.

It can also be quite noisy, but you should still be able to speak to your radiologist during the scan via a microphone inside the MRI if you need to. You will need to stay very still throughout the scan. 

You may also feel a bit uncomfortable having your scrotum positioned and stabilised, but remember that it’s an important part of looking after your health and getting the right treatment as promptly as possible.   

Getting the Results

Your doctor will review your results and discuss any findings with you within a few days. If you need further treatment, they will explain why and what that might include, such as medication, surgery, or additional testing. 

Normal Vs Abnormal Results

A normal MRI scan result will show that:

• Both testicles are similar in size, shape and structure

• The tissue emits even signals, showing no signs of testicular masses, swelling, or fluid buildup.

• Blood flow will look normal (if contrast was used).

• There are unusual lumps, injuries or signs of inflammation or scrotal diseases. 

If your MRI results aren’t normal, the scan may show changes that help explain what’s going on with your testicles or nearby tissues.

• Lumps or masses that could be cancerous or benign, which may appear darker or brighter in the scan results, depending on the type of MRI used. Cancerous lumens may have irregular shapes or uneven borders, while benign, fluid-filled cysts are usually smoother in appearance.

• Swelling or inflammation caused by infections can appear brighter on T2-weighted images. If contrast is used, areas of increased blood flow may appear brighter.

• If the testicles are twisted or injured, they may appear darker since there is reduced blood flow. Tears or ruptures may appear as breaks in normal shapes or structure.

• Hernias may appear as a loop of bowel or fatty tissue extending into the scrotum, often differing in texture from normal testicular tissue.

Costs

Depending on where you live and the options available to you, a testicular MRI (also known as a scrotal MRI) can cost between £250 and £500 in the UK. It may cost slightly more if you need sedation. Sometimes you can find an MRI scan cheaper than this if your clinic offers off-peak pricing.

Get a Testicular MRI

If you’re worried that you or a loved one has symptoms that a problem with the testicles may cause, you can book a private MRI scan today. If you’re unsure whether an MRI is suitable for you, one of our expert clinicians is available for a personalised consultation. They can discuss your symptoms and concerns and help you decide what to do next.

FAQs

What Does an MRI of the Testicles Show?

A testicular MRI can show:

• Tumours

• Twisting of the testicle (torsion)

• Infections (like epididymitis or orchitis)

• Bleeding

• Fluid build-up (like hydroceles or spermatoceles)

• Swollen veins (varicoceles)

• Injuries

• Abscesses (pockets of pus)

• Hernias that extend into the scrotum
  

How Long Does A Testicular MRI Take?

The whole scan takes about 30 to 60 minutes, but allow extra time if contrast dye is used. 

Sources:

How should I assess a person with a scrotal swelling and/or pain? (2024). https://cks.nice.org.uk/topics/scrotal-pain-swelling/diagnosis/assessment/

Raise PSA. (2024). https://www.baus.org.uk/patients/conditions/10/raised_psa/

Scrotum. (2024). https://radiopaedia.org/articles/scrotum?lang=gb

Testicular Cancer. (2022). https://my.clevelandclinic.org/health/diseases/12183-testicular-cancer

Thomas, K. L., et al. (2020). The role of diagnostic imaging in the primary testicular cancer: initial staging, response assessment and surveillance. https://pmc.ncbi.nlm.nih.gov/articles/PMC6995841/

Tsili, A. C., et al. (2022). An Overview of the Role of Multiparametric MRI in the Investigation of Testicular Tumors. https://www.mdpi.com/2072-6694/14/16/3912