Tsili Athina C, Sofikitis Nikolaos, Pappa Ourania, Bougia Christina K, Argyropoulou Maria I
Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10 Ioannina, Greece.
Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10 Ioannina, Greece.
Cancers (Basel). 2022 Aug 13;14(16):3912. doi: 10.3390/cancers14163912.
Conventional ultrasonography represents the mainstay of testis imaging. In cases in which ultrasonography is inconclusive, scrotal MRI using a multiparametric protocol may be used as a useful problem-solving tool. MRI of the scrotum is primarily recommended for differentiating between benign and malignant testicular masses when sonographic findings are ambiguous. This technique is also accurate in the preoperative local staging of testicular tumors and, therefore, is recommended in patients scheduled for testis-sparing surgery. In addition, MRI may provide valuable information regarding the histological characterization of testicular germ-cell tumors, in selected cases. Scrotal MRI may also help in the differentiation between testicular germ-cell neoplasms and non-germ-cell neoplasms. Axial T1-weighted imaging, axial and coronal T2-weighted imaging, axial diffusion-weighted imaging, and coronal subtracted dynamic contrast-enhanced imaging are the minimum requirements for scrotal MRI. A variety of MRI techniques-including diffusion tensor imaging, magnetization transfer imaging, proton MR spectroscopy, volumetric apparent diffusion coefficient histogram analysis, and MRI-based radiomics-are being investigated for testicular mass characterization, providing valuable supplementary diagnostic information. In the present review, we aim to discuss clinical indications for scrotal MRI in cases of testicular tumors, along with MRI findings of common testicular malignancies.
传统超声检查是睾丸成像的主要手段。在超声检查结果不明确的情况下，使用多参数方案的阴囊MRI可作为一种有用的解决问题的工具。当超声检查结果不明确时，主要推荐阴囊MRI用于鉴别睾丸肿块的良恶性。该技术在睾丸肿瘤的术前局部分期中也很准确，因此，对于计划进行保留睾丸手术的患者推荐使用。此外，在某些情况下，MRI可能提供有关睾丸生殖细胞肿瘤组织学特征的有价值信息。阴囊MRI也有助于区分睾丸生殖细胞肿瘤和非生殖细胞肿瘤。轴向T1加权成像、轴向和冠状T2加权成像、轴向扩散加权成像以及冠状减影动态对比增强成像，是阴囊MRI的最低要求。包括扩散张量成像、磁化传递成像、质子磁共振波谱、体积表观扩散系数直方图分析以及基于MRI的放射组学在内的多种MRI技术，正在被用于睾丸肿块的特征描述，提供有价值的补充诊断信息。在本综述中，我们旨在讨论睾丸肿瘤病例中阴囊MRI的临床适应证，以及常见睾丸恶性肿瘤的MRI表现。
