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Tsili AC, Argyropoulou MI, Dolciami M, et al. When to ask for an MRI of the scrotum. Andrology. 2021;9(5):1395-1409doi: 10.1111/andr.13032.
Tsili, A. C., Argyropoulou, M. I., Dolciami, M., Ercolani, G., Catalano, C., & Manganaro, L. (2021). When to ask for an MRI of the scrotum. Andrology, 9(5), 1395-1409. https://doi.org/10.1111/andr.13032
Tsili, Athina C, et al. "When to ask for an MRI of the scrotum." Andrology vol. 9,5 (2021): 1395-1409. doi: https://doi.org/10.1111/andr.13032
Tsili AC, Argyropoulou MI, Dolciami M, Ercolani G, Catalano C, Manganaro L. When to ask for an MRI of the scrotum. Andrology. 2021 Sep;9(5):1395-1409. doi: 10.1111/andr.13032. Epub 2021 Jun 11. PMID: 33964115; PMCID: PMC8596813.
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Andrology. 2021 Sep;9(5):1395-1409. doi: 10.1111/andr.13032. Epub 2021 Jun 11.

When to ask for an MRI of the scrotum.

Andrology

Athina C Tsili, Maria I Argyropoulou, Miriam Dolciami, Giada Ercolani, Carlo Catalano, Lucia Manganaro

Affiliations

  1. Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
  2. Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Roma, Italy.

PMID: 33964115 PMCID: PMC8596813 DOI: 10.1111/andr.13032

Abstract

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.

© 2021 The Authors. Andrology published by Wiley Periodicals LLC on behalf of American Society of Andrology and European Academy of Andrology.

Keywords: magnetic resonance imaging; multiparametric magnetic resonance imaging; scrotum; testicular neoplasms; testis

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