US–MR Imaging Correlation in Pathologic Conditions of the Scrotum

Abstract

Ultrasonography (US) is usually the initial imaging modality for evaluation of pathologic conditions of the scrotum. However, magnetic resonance (MR) imaging can be useful as a problem-solving tool when sonographic findings are equivocal. MR imaging allows characterization of scrotal masses as intratesticular or extratesticular and can demonstrate various types of lesions and tissue, including cysts or fluid, solid masses, fat, and fibrosis. MR imaging may be of value when the location of a scrotal mass is uncertain or when US does not allow differentiation between a solid mass and an inflammatory or vascular abnormality. Gadolinium-enhanced MR imaging can help differentiate between a benign cystic lesion and a cystic neoplasm. Gadolinium-enhanced imaging can also be used to demonstrate areas of absent or reduced testicular perfusion, such as in segmental testicular infarct. Finally, MR imaging can demonstrate an intraabdominal undescended testis, which can be difficult to detect with US, and is superior to US in differentiation between an undescended testis and testicular agenesis.

Right Testicular Seminoma in Bilateral Cryptorchidism: A Case Report

“…In general approximately 95% of malignant testicular tumors are germ cell tumors, of which seminoma is the most common histological subtype. Compared to the non-seminomatous germ cell tumors, seminoma occurs in an older patient population, with a mean age of approximately 40 years [2]. These tumors carry a favorable prognosis due to their sensitivity to radiation and chemotherapy [2].…”

Imaging features of a huge spermatic cord leiomyosarcoma: Review of the literature

“…Although the ultrasound findings alone should have raised the probability of malignancy, the differential diagnosis of the extratesticular lesions in general is not so limited. Apart from purely cystic extratesticular lesions (epididymal cyst, scrotal tunica cyst) most of the solid lesions, either benign (adenoid tumor, papillary epididymal cystadenoma, fibrous pseudotumor, inguinoscrotal hernia, lipoma, leiomyoma) or malignant (rhabdomyosarcoma, liposarcoma, leiomyosarcoma, mesothelioma), frequently have overlapping characteristics, making it extremely difficult to exclude malignancy [18,19] . Considering the above imaging features the mass was more compatible with a leiomyosarcoma (exclusion of rhabdomyosarcoma due to the age of the patient), even though the diagnosis of a benign leiomyoma or a fibrous pseudotumor could not be completely excluded [18][19][20] .…”

Sonography of the acute scrotum in children

“…In post-pubertal male patients it is usually related to retrograde extension of infection spreads from the bladder or prostate gland, through the vas deferens and the lymphatics of the spermatic cord to the epididymis, and eventually reaches the testicle, causing epididymo-orchitis (20-40%) (22,23). In pre-pubertal boys epididymo-orchitis is mostly idiopathic, but can be related to underlying urogenital anomalies (24).…”