Color-Doppler Ultrasound and New Imaging Techniques in Andrological Examination

Abstract

Imaging of the male genital tract (MGT) has assumed growing importance in andrological evaluation, playing a key role in specific issues. In particular, color-Doppler ultrasound (CDUS) is widely used to assess MGT abnormalities, providing useful information on three main andrological topics: infertility, testicular malignancy, and male accessory gland infection. Scrotal CDUS is very useful in assessing (1) scrotal organs and abnormalities when physical examination is unreliable; (2) signs of testicular dysgenesis, often related to sperm abnormalities and to a higher risk of cancer, and testicular lesions suggestive of malignancy; (3) scrotal pain, signs of inflammation (including epididymo-orchitis), and andrological emergencies (including testicular torsion); (4) varicocele; and (5) congenital absence of vas deferens (along with transrectal CDUS). Transrectal CDUS is useful in detecting signs suggestive of (1) MGT obstruction, including ejaculatory duct abnormalities, prostate median cysts, or SV enlargement/emptying impairment and (2) prostate and SV inflammation. However, MGT-CDUS still suffers from a lack of standardization, which is advisable. Along with CDUS, new imaging techniques, such as contrast-enhanced ultrasound, elastography, and magnetic resonance, have been proposed for improving MGT imaging. Even if they are promising, currently, there is not enough evidence for their routine use, with the exception of some specific indications.