{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:06Z","timestamp":1787013846624,"version":"build-2736575974"},"reference-count":201,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T00:00:00Z","timestamp":1624579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ultrasonography is the gold standard imaging method for scrotal investigation. Colour Doppler ultrasonography, contrast\u2010enhanced ultrasonography and sonoelastography allow sonographers to assess size, echotexture, vascular features and stiffness of the scrotal organs and abnormalities. Scrotal ultrasonography has been used to investigate male reproductive health, scrotal pain, masses and trauma. However, ultrasonography thresholds\/classifications used to distinguish normal and pathologic features of the scrotal organs have changed over time, and have not yet been fully standardized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate historical trends for the standards in scrotal ultrasonography: what was, what is and what will be normal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An extensive Medline search was performed identifying the most relevant studies in the English language from inception to date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We provide here (i) a brief overview of the history of ultrasonography, (ii) current indications for scrotal ultrasonography and (iii) previous and current normal values, cut\u2010offs and classifications of the main colour\u2010Doppler ultrasonography parameters\/characteristics of the scrotal organs, as derived from recent guidelines and evidence\u2010based studies. In addition, we report recommendations and the clinical utility of contrast\u2010enhanced ultrasonography and sonoelastography. Finally, we discuss critical issues needing further evidence and future directions to fill in the current gaps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Several studies on scrotal ultrasonography are available. However, guidelines\/recommendations dealing with specific ultrasonography applications have been published only in recent years. More recently, the European Academy of Andrology published evidence\u2010based scrotal colour\u2010Doppler ultrasonography reference ranges\/normative parameters derived from a cohort of healthy, fertile men. In addition, a standardization of the methodology to evaluate qualitative and quantitative colour\u2010Doppler ultrasonography parameters was reported. Other international societies reported indications, methodological standards, clinical utility and limitations of contrast\u2010enhanced ultrasonography and sonoelastography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>To date, colour\u2010Doppler ultrasonography normative values for the scrotal organs are available. However, a wide international consensus on assessment and classification of several ultrasonography parameters is still lacking. An alignment of the world societies on these issues is advocated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.13062","type":"journal-article","created":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T00:45:59Z","timestamp":1622853959000},"page":"1331-1355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Historical trends for the standards in scrotal ultrasonography: What was, what is and what will be normal"],"prefix":"10.1111","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8343-1807","authenticated-orcid":false,"given":"Francesco","family":"Lotti","sequence":"first","affiliation":[{"name":"Andrology, Female Endocrinology and Gender Incongruence Unit Department of Experimental Clinical and Biomedical Sciences University of Florence Florence 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