ABSTRACT
Assessment of male infertility includes clinical examination, laboratory tests (semen analysis, hormones dosage) and sonographic examination of the urogenital tract. Male infertility is due to testicular abnormalities (secretory type) or obstructive disorder (excretory type). Imaging should provide accurate definition of anatomical causes of infertility in order to deliver appropriate treatment. Testicular Doppler ultrasound with transrectal ultrasound is the gold standard imaging technique to explore male infertility. MRI, because of its high resolution, provides a multiplanar study especially in congenital and inflammatory abnormalities of the urogenital tract. This pictorial review illustrates the most frequent causes of male infertility.
Subject(s)
Diagnostic Imaging/methods , Infertility, Male/pathology , Humans , Infertility, Male/diagnostic imaging , Infertility, Male/etiology , Magnetic Resonance Imaging , Male , Semen Analysis , Testicular Diseases/complications , Testicular Diseases/pathology , Testicular Diseases/physiopathology , Testis/abnormalities , Testis/diagnostic imaging , Testis/pathology , UltrasonographyABSTRACT
PURPOSE: To redefine and evaluate the computed tomographic criteria for the diagnosis of renal oncocytoma (RO) for which renal sparing surgery should be preferred. MATERIAL AND METHOD: Retrospective study of 57 patients with 69 RO. Macroscopic and histological correlation was obtained in all cases. A double blinded comparative study was made of 60 renal tumors (containing adenocarcinomas and oncocytomas) larger than 3 cm in diameter in order to evaluate the redefined CT diagnostic criteria. RESULTS: Among RO larger than 3 cm in diameter, 55% presented a sharply defined low attenuation scar on post-contrast scans at the tubular nephrographic phase, central or eccentric, with homogeneous attenuation throughout the remainder of the hypervascular tumor which was classified in 3 different groups. The use of our CT diagnostic criteria gave a statistically significant (p < 0.05) Kappa index of inter-observer concordance of 0.71 and a specificity of 96% for the diagnosis of RO. CONCLUSION: Our redefined computed tomographic criteria for the diagnosis of renal oncocytoma, eventually associated with renal biopsy, should increase the indications for renal sparing surgery for RO larger than 3 cm in diameter.
Subject(s)
Adenoma, Oxyphilic/diagnostic imaging , Kidney Diseases/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Despite the limitations of US in providing a complete evaluation of renal tumors before treatment planning, initial screening, characterization of renal masses and staging of RCCs can benefit from some recent advances of the technique. One of the most relevant clinical benefits of US is the increased early detection of RCCs. Recent technical improvement of gray-scale imaging has increased US performance in the detection of small renal tumors. Combined gray-scale and color Doppler US findings may strongly suggest the histopathologic nature of a renal tumor with respect to the size, the US attenuation characteristics, and the vascular distribution of the lesion. Ultrasound contributes additional diagnostic information for differential diagnosis of some renal masses that remain equivocal at CT, including: atypical cystic lesions; solid renal tumors with poor vascularity; and angiomyolipomas with minimal fat component. Ultrasound also may provide additional diagnostic information over CT in selected cases of RCCs with venous invasion. In addition to some diagnostic and therapeutic procedures that can benefit from US guidance, intraoperative US remains the only available tool that enables to ensure renal-parenchymal-sparing surgery.
