Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Roma, Italy.
Andrology. 2021 Sep;9(5):1395-1409. doi: 10.1111/andr.13032. Epub 2021 Jun 11.
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.
To update current research on when to ask for an MRI of the scrotum.
PubMed database was searched for original articles and reviews published during 2010-2021.
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.
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.
阴囊多参数 MRI（mpMRI）已被确立为阴囊疾病检查的一种有用的二线诊断工具。最近，欧洲泌尿生殖放射学会阴囊和阴茎影像学工作组发布了关于阴囊 MRI 临床适应证的建议。
更新当前关于何时要求进行阴囊 MRI 的研究。
在 2010 年至 2021 年期间，在 PubMed 数据库中搜索了原始文章和综述。
符合搜索标准的有 83 篇文章。阴囊 MRI 主要推荐用于超声检查结果不确定或与临床检查不一致的情况下，应在以下情况下进行检查：鉴别睾丸内和睾丸旁病变（在超声检查结果不确定的罕见情况下）、描述睾丸旁和睾丸内病变（当超声检查结果不确定时）、鉴别生殖细胞和性索-间质睾丸肿瘤、睾丸恶性肿瘤的局部分期（在计划保留睾丸手术的患者中）、鉴别精原细胞瘤和非精原细胞瘤肿瘤（当计划立即进行化疗且延迟进行睾丸切除术时）、评估急性阴囊和阴囊创伤（很少需要，在超声检查结果不确定的情况下）以及检测和定位未降睾丸（在超声检查结果不确定的情况下）。虽然初步数据显示在评估男性不育方面有有前景的结果，但 mpMRI 尚未确立其作用。
阴囊多参数 MRI 通过评估形态和功能数据，代表了一种有价值的解决问题的工具，有助于提高我们对阴囊病理学性质和精子发生过程的理解。该技术可以改善患者的护理并减少不必要的手术数量。
