Magnetic resonance imaging of the scrotum: pictorial review with ultrasound correlation

Mathur, Mahan; Mills, Ian; Spektor, Michael

doi:10.1007/s00261-017-1127-2

Cited by 11 publications

(46 citation statements)

References 69 publications

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“…Accurate characterization of the nature of paratesticular lesions is of outmost importance to allow planning of a conservative treatment in benign lesions, such as surveillance, excision, or TSS. The US characteristics of paratesticular tumors are usually overlapping, and therefore, scrotal MRI is strongly recommended as a valuable supplemental technique, to define lesion location and extent and to suggest a possible histologic diagnosis 6,8,29,30,33,36,42–45 …”

Section: Resultsmentioning

confidence: 99%

“…On MRI, adenomatoid tumor usually appears hypointense on T2WI, with slow or decreased contrast enhancement, relative to the normal testis (Figure 2). 30,36,111 …”

Section: Resultsmentioning

confidence: 99%

“…24 MRI is highly sensitive in the characterization of benign intratesticular lesions, by depicting the presence of fluid, fat, fibrous tissue, blood products, myxoid, and granulation tissue . [6][7][8][9]11,12,14,[24][25][26][27][28][29][30][33][34][35][36][37]42,48,[50][51][52][53]56 The overall accuracy of MRI in the characterization of benign testicular diseases has been reported 87.5%, and the NPV 100%. 48 The absence of contrast enhancement represents a highly sensitive sign in characterizing the benign nature of intratesticular lesions.…”

Section: Intratesticular Lesionsmentioning

confidence: 99%

“…Multiparametric MRI (mpMRI) of the scrotum has emerged as a valuable supplemental technique for the investigation of scrotal pathology 7–9,11,12,15,24–46 . Scrotal MRI due to the wide field of view and multiplanar capabilities depicts in excellent anatomic detail both testes, epididymides, spermatic cords, and inguinal regions.…”

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: Resultsmentioning

confidence: 99%

“…On MRI, adenomatoid tumor usually appears hypointense on T2WI, with slow or decreased contrast enhancement, relative to the normal testis (Figure 2). 30,36,111 …”

Section: Resultsmentioning

confidence: 99%

Section: Intratesticular Lesionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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When to ask for an MRI of the scrotum

et al. 2021

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“…Currently, scrotal MRI is considered an effective, complementary diagnostic tool for the investigation of abnormal testis (Aganovic & Cassidy, 2012; Mathur, Mills, & Spektor, 2017; Tsili et al, 2014, 2018). 1H‐MRS has recently been added as an adjunct tool to conventional MRI that might serve as a bridge between metabolism and anatomical and physiological changes taking place within previously determined VOIs in normal and pathologic testis (Aaronson et al, 2010; Baleato‐Gonzalez et al, 2015; Firat et al, 2008; Parenti et al, 2016; Storey et al, 2018; Tsili et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Are there differences in the biochemical profile of bilateral normal testes? A 3.0 T 1H‐MR spectroscopy study

et al. 2020

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Bilateral normal testes asymmetry represents an interesting phenomenon. The aim was to assess possible differences in the biochemical profile of bilateral normal testes by 3.0 T proton magnetic resonance spectroscopy (1H‐MRS). Twenty‐one men were examined with scrotal 3.0 T MRI, including a single‐voxel point‐resolved spectroscopy sequence. MR spectra were obtained by placing a volume of interest in the middle of each normal testis. Normalised metabolite concentrations, defined as ratios of the calculated metabolite concentrations relative to creatine (Cr) concentration, were compared between bilateral normal testes using Mann–Whitney U test. 1H‐MRS allowed the detection of certain testicular metabolites, including total choline, Cr, myo‐inositol, Glx, total lipids and macromolecules resonating at 0.9, 1.3 and 2.0 ppm. Normal left testis had higher median normalised concentrations of Glx (p = .002) and lactate (p = .041) compared with the normal right testis. Differences in concentrations of Glx were attributed to differences in glutamate (p = .020). Normal testes asymmetry is confirmed in this study by differences in the biochemical testicular profile, as assessed by 3.0 T 1H‐MRS. Increase in levels of glutamate and lactate in normal left testis should be correlated with changes in metabolic pathways, specifically glycometabolism and amino acid metabolism.

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Proton MR Spectroscopy in Assessing the Biochemical Milieu of Human Testes

Tsili

Astrakas

Sofikitis

et al. 2020

Magnetic Resonance Imaging

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Proton magnetic resonance spectroscopy (MRS), considered a connection between metabolism and anatomic and functional information provided by standard MRI, gives information on various tissue metabolites and their pathologic changes. Recently, proton MRS has been added as an adjunct tool to the multiparametric protocol of scrotal MRI, providing a new insight into the extremely complex biochemical milieu of normal and abnormal testes. This article reviews proton MR spectra of normal testes, showing age and bilateralism dependence. Disturbances of various metabolic pathways in testes of infertile men resulting in alterations of metabolite peaks are discussed. Preliminary data on proton MR spectra of testicular mass lesions are presented. Level of Evidence: 5. Technical Efficacy Stage: 5.

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Magnetic resonance imaging of the scrotum: pictorial review with ultrasound correlation

Cited by 11 publications

References 69 publications

When to ask for an MRI of the scrotum

When to ask for an MRI of the scrotum

Are there differences in the biochemical profile of bilateral normal testes? A 3.0 T 1H‐MR spectroscopy study

Proton MR Spectroscopy in Assessing the Biochemical Milieu of Human Testes

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