Imaging of scrotal masses

Sharbidre, Kedar G; Lockhart, Mark E.

doi:10.1007/s00261-019-02395-4

Cited by 16 publications

(43 citation statements)

References 76 publications

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“…118 Lesion enucleation may be suggested for ECs <3 cm and typical imaging findings, in patients with negative tumor markers, although intraoperative frozen section is needed to confirm the diagnosis. 7 MRI may provide confirmatory findings and is mainly recommended as a second-line tool in cases of equivocal US findings. MRI findings specific for the diagnosis of an EC include the presence of a rounded or oval encapsulated intratesticular lesion, surrounded by a hypointense T2 halo, not enhancing after gadolinium administration (Figure 3), with the characteristic "onion skin sign" appearance on T2WI…”

Section: Intratesticular Lesionsmentioning

confidence: 99%

“…MRI is also useful in discriminating between an undescended testis and testicular agenesis. 7,35,36,42 DWI and T2WI with fat saturation increase the diagnostic performance of MRI in the detection and localization of impalpable, undescended testes. 24 Information on testis viability may be provided at DWI, with testes of low DWI signal considered nonviable.…”

Section: Scrotal Traumamentioning

confidence: 99%

“…MRI findings may narrow differential diagnosis, helping in planning more precise treatment strategies and reducing the need of unnecessary surgical explorations. [7][8][9]11,12,15, Recently, the Scrotal and Penile Imaging Working Group (SPIWG) appointed by the board of the European Society of Urogenital Radiology (ESUR) has produced recommendations on clinical indications for scrotal MRI, based on literature published before 2016 and combined expertise of the group. 24 MRI of the scrotum is primarily recommended for the characterization of paratesticular and intratesticular lesions in questionable cases, when US findings are indeterminate and for the identification and localization of undescended testes.…”

Section: Introductionmentioning

confidence: 99%

“…The detection of a thin, hypointense, well-defined halo, best depicted on T2WI, lying between the lesion and the adjacent testicular parenchyma, corresponding to the tunica albuginea, helps to suggest lesion origin. [5][6][7][8]24,25,29,33,[42][43][44][45] MRI proved to be capable of identifying the correct lesion location with sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 100%, each, in a study including 84 patients with suspected scrotal masses. 35…”

Section: Introductionmentioning

confidence: 99%

“…6 Viruses may persist in semen and last longer in seminal fluid than in other body fluids due to the immune privilege of the testes and the contribution of the blood-testes barrier to resistance to therapeutic agents. 7,8 Semen may also have higher loads of viruses, such as Zika virus, than blood. 9,10 Therefore, the testes may act as a reservoir of virus, which may cause imprecise evaluation of viral clearance in patients.…”

Section: Introductionmentioning

confidence: 99%

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When to ask for an MRI of the scrotum

et al. 2021

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Background: Multiparametric MRI (mpMRI) of the scrotum has been established as a useful second-line diagnostic tool for the investigation of scrotal diseases. Recently, recommendations on clinical indications for scrotal MRI were issued by the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology. Objective: To update current research on when to ask for an MRI of the scrotum. Methods: PubMed database was searched for original articles and reviews published during 2010-2021.Results: Eighty-three articles fulfilled the search criteria. Scrotal MRI is mainly recommended after inconclusive US findings or inconsistent with the clinical examination and should be asked in the following cases: differentiation between intratesticular and paratesticular lesions (in rare cases of uncertain US findings), characterization of paratesticular and intratesticular lesions (when US findings are indeterminate), discrimination between germ cell and sex cord-stromal testicular tumors, local staging of testicular malignancies (in patients planned for testis-sparing surgery), differentiation between seminomas and non-seminomatous tumors (when immediate chemotherapy is planned and orchiectomy is delayed), assessment of acute scrotum and scrotal trauma (rarely needed, in cases of non-diagnostic US findings) and detection and localization of undescended testes (in cases of inconlusive US findings). Although preliminary data show promising results in the evaluation of male infertility, no established role for mpMRI still exists. Conclusion:Multiparametric MRI of the scrotum, by assessing morphologic and functional data represents a valuable problem-solving tool, helping to improve our understanding on the nature of scrotal pathology and the process of spermatogenesis. The technique may improve patient care and reduce the number of unnecessary surgical procedures.

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Section: Intratesticular Lesionsmentioning

confidence: 99%