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Multiparametric US for scrotal diseases

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Abstract

Multiparametric US is increasingly recognized as a valuable problem-solving technique in scrotal pathologies. Compared to conventional Doppler modes, contrast-enhanced ultrasonography (CEUS) has higher sensitivity in assessing the presence or absence of flows, and to improve differentiation between poorly vascularized tumors and non-neoplastic, avascular lesions. Characterization of benign and malignant complex cysts is improved. In trauma patients, CEUS can help evaluating the viability of testicular parenchyma. In patients with severe epididymo-orchitis, it allows unequivocal assessment of post-inflammatory ischemic changes and abscess formation. CEUS does not add significantly to conventional Doppler modes in spermatic cord torsion. Attempt of differentiating benign and malignant tumors remains a research tool. In the clinical practice, elastography has a limited role for tumor characterization. The majority of malignant tumors are stiff at elastography, but they may display soft areas, or appear globally soft. A quantitative evaluation of testicular stiffness is feasible using shear-wave elastography. Potential clinical applications for elastographic modes could include work-up of infertile patients.

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Abbreviations

CEUS:

Contrast-enhanced ultrasonography

MRI:

Magnetic resonance imaging

US:

Ultrasonography

References

  1. Dalla Palma L, Bertolotto M (1999) Introduction to ultrasound contrast agents: physics overview. Eur Radiol 9(3):S338–S342

    Article  PubMed  Google Scholar 

  2. Bertolotto M, Bartolotta TV, Calderan L, et al. (2006) Contrast enhanced ultrasonography for focal liver lesions characterization: clinical perspective. Curr Med Imaging Rev 2(3):373–383. https://doi.org/10.2174/157340506777934561

    Article  Google Scholar 

  3. Piscaglia F, Nolsoe C, Dietrich CF, et al. (2012) The EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med 33(1):33–59. https://doi.org/10.1055/s-0031-1281676

    Article  CAS  PubMed  Google Scholar 

  4. Bertolotto M, Serafini G, Sconfienza LM, et al. (2014) The use of CEUS in the diagnosis of retinal/choroidal detachment and associated intraocular masses-preliminary investigation in patients with equivocal findings at conventional ultrasound. Ultraschall Med 35(2):173–180. https://doi.org/10.1055/s-0032-1330321

    CAS  PubMed  Google Scholar 

  5. Rubenthaler J, Paprottka K, Marcon J, et al. (2016) Comparison of magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear solid renal lesions. Clin Hemorheol Microcirc 64(4):757–763. https://doi.org/10.3233/CH-168034

    Article  CAS  PubMed  Google Scholar 

  6. Barr RG, Peterson C, Hindi A (2014) Evaluation of indeterminate renal masses with contrast-enhanced US: a diagnostic performance study. Radiology 271(1):133–142. https://doi.org/10.1148/radiol.13130161

    Article  PubMed  Google Scholar 

  7. Kim TK, Noh SY, Wilson SR, et al. (2017) Contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) 2017: a review of important differences compared to the CT/MRI system. Clin Mol Hepatol 23(4):280–289. https://doi.org/10.3350/cmh.2017.0037

    Article  PubMed  PubMed Central  Google Scholar 

  8. Piscaglia F, Bolondi L, Italian Society for Ultrasound in M, Biology Study Group on Ultrasound Contrast A (2006) The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound Med Biol 32(9):1369–1375. https://doi.org/10.1016/j.ultrasmedbio.2006.05.031

    Article  PubMed  Google Scholar 

  9. Cochran ST, Bomyea K, Sayre JW (2001) Trends in adverse events after IV administration of contrast media. AJR Am J Roentgenol 176(6):1385–1388. https://doi.org/10.2214/ajr.176.6.1761385

    Article  CAS  PubMed  Google Scholar 

  10. Hunt CH, Hartman RP, Hesley GK (2009) Frequency and severity of adverse effects of iodinated and gadolinium contrast materials: retrospective review of 456,930 doses. AJR Am J Roentgenol 193(4):1124–1127. https://doi.org/10.2214/AJR.09.2520

    Article  PubMed  Google Scholar 

  11. Girometti R, Stocca T, Serena E, Granata A, Bertolotto M (2017) Impact of contrast-enhanced ultrasound in patients with renal function impairment. World J Radiol 9(1):10–16. https://doi.org/10.4329/wjr.v9.i1.10

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bamber J, Cosgrove D, Dietrich CF, et al. (2013) EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: basic principles and technology. Ultraschall Med 34(2):169–184. https://doi.org/10.1055/s-0033-1335205

    Article  CAS  PubMed  Google Scholar 

  13. Cosgrove D, Piscaglia F, Bamber J, et al. (2013) EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications. Ultraschall Med 34(3):238–253. https://doi.org/10.1055/s-0033-1335375

    Article  CAS  PubMed  Google Scholar 

  14. Goddi A, Sacchi A, Magistretti G, Almolla J, Salvadore M (2012) Real-time tissue elastography for testicular lesion assessment. Eur Radiol 22(4):721–730. https://doi.org/10.1007/s00330-011-2312-2

    Article  PubMed  Google Scholar 

  15. Aigner F, De Zordo T, Pallwein-Prettner L, et al. (2012) Real-time sonoelastography for the evaluation of testicular lesions. Radiology 263(2):584–589. https://doi.org/10.1148/radiol.12111732

    Article  PubMed  Google Scholar 

  16. Camoglio FS, Bruno C, Peretti M, et al. (2017) The role of sonoelastography in the evaluation of testes with varicocele. Urology 100:203–206. https://doi.org/10.1016/j.urology.2016.08.005

    Article  PubMed  Google Scholar 

  17. Rocher L, Criton A, Gennisson JL, et al. (2017) Testicular shear wave elastography in normal and infertile men: a prospective study on 601 patients. Ultrasound Med Biol 43(4):782–789. https://doi.org/10.1016/j.ultrasmedbio.2016.11.016

    Article  PubMed  Google Scholar 

  18. Kantarci F, Cebi Olgun D, Mihmanli I (2012) Shear-wave elastography of segmental infarction of the testis. Korean J Radiol 13(6):820–822. https://doi.org/10.3348/kjr.2012.13.6.820

    Article  PubMed  PubMed Central  Google Scholar 

  19. Auer T, De Zordo T, Dejaco C, et al. (2017) Value of multiparametric US in the assessment of intratesticular lesions. Radiology 285(2):640–649. https://doi.org/10.1148/radiol.2017161373

    Article  PubMed  Google Scholar 

  20. Sidhu PS, Piscaglia F, Bartels E, et al. (2018) The EFSUMB guidelines and recommendations for the clinical practice of contrast enhanced ultrasound (CEUS) in non-hepatic applications: update 2017. Ultraschall Med-Eur J Ultrasound 33(1):33–59

    Google Scholar 

  21. Schroder C, Lock G, Schmidt C, Loning T, Dieckmann KP (2016) Real-time elastography and contrast-enhanced ultrasonography in the evaluation of testicular masses: a comparative prospective study. Ultrasound Med Biol 42(8):1807–1815. https://doi.org/10.1016/j.ultrasmedbio.2016.03.026

    Article  PubMed  Google Scholar 

  22. Trottmann M, Marcon J, D’Anastasi M, et al. (2016) Shear-wave elastography of the testis in the healthy man-determination of standard values. Clin Hemorheol Microcirc 62(3):273–281. https://doi.org/10.3233/CH-162046

    Article  CAS  PubMed  Google Scholar 

  23. Badea R, Lucan C, Suciu M, Vasile T, Gersak M (2016) Contrast enhanced harmonic ultrasonography for the evaluation of acute scrotal pathology. A pictorial essay. Med Ultrason 18(1):110–115. https://doi.org/10.11152/mu.2013.2066.181.esy

    Article  PubMed  Google Scholar 

  24. Valentino M, Bertolotto M, Derchi L, et al. (2011) Role of contrast enhanced ultrasound in acute scrotal diseases. Eur Radiol 21(9):1831

    Article  PubMed  Google Scholar 

  25. Cassar S, Bhatt S, Paltiel HJ, Dogra VS (2008) Role of spectral Doppler sonography in the evaluation of partial testicular torsion. J Ultrasound Med 27(11):1629–1638

    Article  PubMed  Google Scholar 

  26. Lee FT Jr, Winter DB, Madsen FA, et al. (1996) Conventional color Doppler velocity sonography versus color Doppler energy sonography for the diagnosis of acute experimental torsion of the spermatic cord. AJR Am J Roentgenol 167(3):785–790. https://doi.org/10.2214/ajr.167.3.8751701

    Article  PubMed  Google Scholar 

  27. Mernagh JR, Caco C, De Maria J (2004) Testicular torsion revisited. Curr Probl Diagn Radiol 33(2):60–73. https://doi.org/10.1016/j.cpradiol.2003.11.004

    Article  PubMed  Google Scholar 

  28. Wilson SR, Burns PN (2010) Microbubble-enhanced US in body imaging: what role? Radiology 257(1):24–39. https://doi.org/10.1148/radiol.10091210

    Article  PubMed  Google Scholar 

  29. Coley BD, Frush DP, Babcock DS, et al. (1996) Acute testicular torsion: comparison of unenhanced and contrast-enhanced power Doppler US, color Doppler US, and radionuclide imaging. Radiology 199(2):441–446. https://doi.org/10.1148/radiology.199.2.8668791

    Article  CAS  PubMed  Google Scholar 

  30. O’Hara SM, Frush DP, Babcock DS, et al. (1996) Doppler contrast sonography for detecting reduced perfusion in experimental ischemia of prepubertal rabbit testes. Acad Radiol 3(4):319–324

    Article  PubMed  Google Scholar 

  31. Paltiel HJ, Kalish LA, Susaeta RA, et al. (2006) Pulse-inversion US imaging of testicular ischemia: quantitative and qualitative analyses in a rabbit model. Radiology 239(3):718–729. https://doi.org/10.1148/radiol.2393050210

    Article  PubMed  Google Scholar 

  32. Cosgrove DO, Kiely P, Williamson R, Blomley MJ, Eckersley RJ (2000) Ultrasonographic contrast media in the urinary tract. BJU Int 86(1):11–17

    PubMed  Google Scholar 

  33. Catalano O, Lobianco R, Sandomenico F, Mattace Raso M, Siani A (2004) Real-time, contrast-enhanced sonographic imaging in emergency radiology. Radiol Med 108(5–6):454–469

    PubMed  Google Scholar 

  34. Moschouris H, Stamatiou K, Lampropoulou E, Kalikis D, Matsaidonis D (2009) Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography? International braz j urol 35(6):692–705

    Article  CAS  PubMed  Google Scholar 

  35. Yusuf GT, Sidhu PS (2013) A review of ultrasound imaging in scrotal emergencies. J Ultrasound 16(4):171–178. https://doi.org/10.1007/s40477-013-0033-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Zhang X, Lv F, Tang J (2015) Shear wave elastography (SWE) is reliable method for testicular spermatogenesis evaluation after torsion. Int J Clin Exp Med 8(5):7089–7097

    PubMed  PubMed Central  Google Scholar 

  37. Bertolotto M, Cantisani V, Valentino M, Pavlica P, Derchi LE (2016) Pitfalls in imaging for acute scrotal pathology. Semin Roentgenol 51(1):60–69. https://doi.org/10.1053/j.ro.2016.02.012

    Article  PubMed  Google Scholar 

  38. Bertolotto M, Derchi LE, Sidhu PS, et al. (2011) Acute segmental testicular infarction at contrast-enhanced ultrasound: early features and changes during follow-up. AJR Am J Roentgenol 196(4):834–841. https://doi.org/10.2214/AJR.10.4821

    Article  PubMed  Google Scholar 

  39. Patel KV, Huang DY, Sidhu PS (2014) Metachronous bilateral segmental testicular infarction: multi-parametric ultrasound imaging with grey-scale ultrasound, Doppler ultrasound, contrast-enhanced ultrasound (CEUS) and real-time tissue elastography (RTE). J Ultrasound 17(3):233–238. https://doi.org/10.1007/s40477-014-0098-1

    Article  PubMed  PubMed Central  Google Scholar 

  40. Jaffer OSSPS (2013) Contrast-enhanced ultrasonography of the testes. Ultrasound Clin 8:509–523

    Article  Google Scholar 

  41. Horstman WG, Melson GL, Middleton WD, Andriole GL (1992) Testicular tumors: findings with color Doppler US. Radiology 185(3):733–737. https://doi.org/10.1148/radiology.185.3.1438754

    Article  CAS  PubMed  Google Scholar 

  42. Ma W, Sarasohn D, Zheng J, Vargas HA, Bach A (2017) Causes of avascular hypoechoic testicular lesions detected at scrotal ultrasound: can they be considered benign? AJR Am J Roentgenol 209(1):110–115. https://doi.org/10.2214/AJR.16.17333

    Article  PubMed  Google Scholar 

  43. Cantisani V, Bertolotto M, Weskott HP, et al. (2015) Growing indications for CEUS: the kidney, testis, lymph nodes, thyroid, prostate, and small bowel. Eur J Radiol 84(9):1675–1684. https://doi.org/10.1016/j.ejrad.2015.05.008

    Article  CAS  PubMed  Google Scholar 

  44. Rocher L, Ramchandani P, Belfield J, et al. (2016) Incidentally detected non-palpable testicular tumours in adults at scrotal ultrasound: impact of radiological findings on management Radiologic review and recommendations of the ESUR scrotal imaging subcommittee. Eur Radiol 26(7):2268–2278. https://doi.org/10.1007/s00330-015-4059-7

    Article  PubMed  Google Scholar 

  45. Drudi FM, Maghella F, Martino G, et al. (2016) Detection of small testicular masses in monorchid patients using US, CPDUS, CEUS and US-guided biopsy. J Ultrasound 19(1):25–28. https://doi.org/10.1007/s40477-015-0158-1

    Article  CAS  PubMed  Google Scholar 

  46. Sidhu PS, Sriprasad S, Bushby LH, Sellars ME, Muir GH (2004) Impalpable testis cancer. BJU Int 93(6):888. https://doi.org/10.1111/j.1464-410X.2004.4737d.x

    Article  CAS  PubMed  Google Scholar 

  47. Bertolotto M, Derchi LE, Secil M, et al. (2015) Grayscale and color Doppler features of testicular lymphoma. J Ultrasound Med 34(6):1139–1145. https://doi.org/10.7863/ultra.34.6.1139

    Article  PubMed  PubMed Central  Google Scholar 

  48. Kachramanoglou C, Rafailidis V, Philippidou M, et al. (2017) Multiparametric sonography of hematologic malignancies of the testis: grayscale, color Doppler, and contrast-enhanced ultrasound and strain elastographic appearances with histologic correlation. J Ultrasound Med 36(2):409–420. https://doi.org/10.7863/ultra.16.02013

    Article  PubMed  Google Scholar 

  49. Bertolotto M, Borsato A, Derchi LE (2014) Lymphoma of the spermatic cord: sonographic appearance. J Clin Ultrasound 42(8):509–512. https://doi.org/10.1002/jcu.22198

    Article  PubMed  Google Scholar 

  50. Conzi R, Damasio MB, Bertolotto M, et al. (2017) Sonography of scrotal wall lesions and correlation with other modalities. J Ultrasound Med 36(10):2149–2163. https://doi.org/10.1002/jum.14257

    Article  PubMed  Google Scholar 

  51. Isidori AM, Pozza C, Gianfrilli D, et al. (2014) Differential diagnosis of nonpalpable testicular lesions: qualitative and quantitative contrast-enhanced US of benign and malignant testicular tumors. Radiology 273(2):606–618. https://doi.org/10.1148/radiol.14132718

    Article  PubMed  Google Scholar 

  52. Drudi FM, Valentino M, Bertolotto M, et al. (2016) CEUS time intensity curves in the differentiation between leydig cell carcinoma and seminoma: a multicenter study. Ultraschall Med 37(2):201–205. https://doi.org/10.1055/s-0034-1398841

    CAS  PubMed  Google Scholar 

  53. Pozza C, Gianfrilli D, Fattorini G, et al. (2016) Diagnostic value of qualitative and strain ratio elastography in the differential diagnosis of non-palpable testicular lesions. Andrology 4(6):1193–1203. https://doi.org/10.1111/andr.12260

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Schurich M, Aigner F, Frauscher F, Pallwein L (2009) The role of ultrasound in assessment of male fertility. Eur J Obstet Gynecol Reprod Biol 144(1):S192–S198. https://doi.org/10.1016/j.ejogrb.2009.02.034

    Article  PubMed  Google Scholar 

  55. Huang DY, Sidhu PS (2012) Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis. Br J Radiol 85(1):S41–S53. https://doi.org/10.1259/bjr/30029741

    Article  PubMed  PubMed Central  Google Scholar 

  56. Valentino M, Bertolotto M, Ruggirello M, et al. (2011) Cystic lesions and scrotal fluid collections in adults: ultrasound findings. J Ultrasound 14(4):208–215. https://doi.org/10.1016/j.jus.2011.10.008

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Bhatt S, Rubens DJ, Dogra VS (2006) Sonography of benign intrascrotal lesions. Ultrasound Q 22(2):121–136

    Article  PubMed  Google Scholar 

  58. Winter TC (2009) There is a mass in the scrotum-what does it mean?: evaluation of the scrotal mass. Ultrasound Q 25(4):195–205. https://doi.org/10.1097/RUQ.0b013e3181c6b42d

    Article  PubMed  Google Scholar 

  59. Patel K, Sellars ME, Clarke JL, Sidhu PS (2012) Features of testicular epidermoid cysts on contrast-enhanced sonography and real-time tissue elastography. J Ultrasound Med 31(1):115–122

    Article  PubMed  Google Scholar 

  60. Lung PF, Jaffer OS, Sellars ME, et al. (2012) Contrast-enhanced ultrasound in the evaluation of focal testicular complications secondary to epididymitis. AJR Am J Roentgenol 199(3):W345–W354. https://doi.org/10.2214/AJR.11.7997

    Article  PubMed  Google Scholar 

  61. Cokkinos DD, Antypa E, Kalogeropoulos I, et al. (2013) Contrast-enhanced ultrasound performed under urgent conditions. Indications, review of the technique, clinical examples and limitations. Insights. Imaging 4(2):185–198. https://doi.org/10.1007/s13244-012-0209-5

    Google Scholar 

  62. Gaur S, Bhatt S, Derchi L, Dogra V (2011) Spontaneous intratesticular hemorrhage: two case descriptions and brief review of the literature. J Ultrasound Med 30(1):101–104

    Article  PubMed  Google Scholar 

  63. Tsili AC, Bertolotto M, Turgut AT, et al. (2018) MRI of the scrotum: recommendations of the ESUR Scrotal and Penile Imaging Working Group. Eur Radiol 28(1):31–43. https://doi.org/10.1007/s00330-017-4944-3

    Article  PubMed  Google Scholar 

  64. Correas JM, Drakonakis E, Isidori AM, et al. (2013) Update on ultrasound elastography: miscellanea. Prostate, testicle, musculo-skeletal. Eur J Radiol 82(11):1904–1912. https://doi.org/10.1016/j.ejrad.2013.05.031

    Article  CAS  PubMed  Google Scholar 

  65. Liguori G, Trombetta C, Ollandini G, et al. (2009) Predictive factors of better improvement in semen quality after sclerotization of varicocele: preliminary report. JAS 16:47–53

    Google Scholar 

  66. Liguori G, Ollandini G, Pomara G, et al. (2010) Role of renospermatic basal reflow and age on semen quality improvement after sclerotization of varicocele. Urology 75(5):1074–1078. https://doi.org/10.1016/j.urology.2009.10.068

    Article  PubMed  Google Scholar 

  67. Gat Y, Zukerman ZVI, Bahcar GN, Feldberg D, Gornish M (2003) Adolescent varicocele: is it a unilateral disease? Pediatric Urology 62(4):742–746

    Article  Google Scholar 

  68. Caretta N, Palego P, Schipilliti M, et al. (2010) Testicular contrast harmonic imaging to evaluate intratesticular perfusion alterations in patients with varicocele. J Urol 183(1):263–269. https://doi.org/10.1016/j.juro.2009.08.140

    Article  PubMed  Google Scholar 

  69. Abdelwahab K, Eliwa AM, Seleem MM, et al. (2017) Role of preoperative testicular shear wave elastography in predicting improvement of semen parameters after varicocelectomy for male patients with primary infertility. Urology 107:103–106. https://doi.org/10.1016/j.urology.2017.04.026

    Article  PubMed  Google Scholar 

  70. Bertolotto MCO (2009) Contrast-enhanced ultrasound: past, present, and future. Ultrasound Clin 4(2009):339–367

    Article  Google Scholar 

  71. Tomizawa M, Shinozaki F, Motoyoshi Y, et al. (2013) Sonoporation: gene transfer using ultrasound. World J Methodol 3(4):39–44. https://doi.org/10.5662/wjm.v3.i4.39

    Article  PubMed  PubMed Central  Google Scholar 

  72. Bekeredjian R, Kuecherer HF, Kroll RD, Katus HA, Hardt SE (2007) Ultrasound-targeted microbubble destruction augments protein delivery into testes. Urology 69(2):386–389. https://doi.org/10.1016/j.urology.2006.12.004

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy

    Michele Bertolotto, Matilda Muça, Francesca Currò & Maria Assunta Cova

  2. Department of Urology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy

    Stefano Bucci

  3. Department of Radiology, Hôpital de Bicêtre, 78 Avenue du General Lecters, 94270, Paris, France

    Laurence Rocher

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  1. Michele Bertolotto
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Correspondence to Michele Bertolotto.

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All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individuals who had contrast agent administration.

Electronic supplementary material

Below is the link to the electronic supplementary material.

261_2018_1510_MOESM1_ESM.mp4

Normal testicular anatomy at CEUS. After microbubble injection, testicular arteries enhance first followed by progressive fill-in of the parenchyma. Supplementary material 1 (MP4 3178 kb)

261_2018_1510_MOESM2_ESM.mp4

Segmental testicular infarction at CEUS. After microbubble injection two adjacent ischemic lobules are identified, separated by an intervening area of viable parenchyma. Supplementary material 2 (MP4 419 kb)

261_2018_1510_MOESM3_ESM.mp4

Patient with post-inflammatory infarction of the left testis. “Spectacle” view of both testes obtained with a transverse plane. The left testis is enlarged and displays complete lack of enhancement. The vascularization of the right testis is normal. Supplementary material 3 (MP4 1979 kb)

261_2018_1510_MOESM4_ESM.mp4

Severe epididymo-orchitis in a patient presenting with right testicular pain and swelling. “Spectacle” view of both testes obtained with a transverse plane. CEUS shows early and intense enhancement of the right testis. Small non-enhancing areas are seen, consistent with micro-abscesses. Enhancement of the normal left testis occurs later and is less intense. Supplementary material 4 (MP4 1937 kb)

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Bertolotto, M., Muça, M., Currò, F. et al. Multiparametric US for scrotal diseases. Abdom Radiol 43, 899–917 (2018). https://doi.org/10.1007/s00261-018-1510-7

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