{"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":1787013846412,"version":"build-2736575974"},"reference-count":56,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The widespread use of ultrasonography has led to an increased number of incidentally detected small non\u2010palpable lesions, with Leydig cell tumours representing the majority of them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The ultrasonography, real\u2010time elastography and contrast\u2010enhanced ultrasonography features of a large series of non\u2010palpable testicular lesions were evaluated, focusing on the differences between Leydig cell tumours and other testicular masses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Of the 4679 testicular ultrasonography examinations performed at the Authors\u2019 Institution between January 2009 and December 2018, 78 patients (1.7%) were incidentally diagnosed with at least one non\u2010palpable lesion and were enrolled. Thirteen patients (16.6%) declined surgery and were thus excluded. The remaining 65 underwent surgical resection with frozen section analysis. The conventional ultrasonography, colour Doppler, real\u2010time elastography and contrast\u2010enhanced ultrasonography were performed by a radiologist having more than 10 years of experience. Demographic and clinical data were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Leydig cell tumours were detected in 32 patients, being the most frequent benign tumours (49.2%); of the non\u2010Leydig cell tumours, 25 patients had malignant tumours, five non\u2010neoplastic lesions and three other benign tumours. The Leydig cell tumour group had mostly infertility problems whereas the non\u2010Leydig cell tumour group frequently experienced pain (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Leydig cell tumours were all hypoechoic (32\/32, 100%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0\n                      <jats:italic>=<\/jats:italic>\n                      \u00a00.002), more frequently presented with well\u2010defined margins compared to non\u2010Leydig cell tumours (30\/32, 93.8%\u00a0vs. 19\/33, 57.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001) and tended to be smaller than non\u2010Leydig cell tumours (5.3\u00a0mm [standard deviation 2.7\u00a0mm] vs. 10.6\u00a0mm [standard deviation 3.8\u00a0mm], respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The vascular pattern characterised by the rapid wash\u2010in followed by the delayed wash\u2010out observed during contrast\u2010enhanced ultrasonography was significantly associated with the Leydig cell tumour histological diagnosis, even at multivariate analysis (odds ratio 480.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and yielded a high diagnostic accuracy (area under the receiver operating characteristic curve 0.954, 95% confidence interval 0.903\u20131).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Contrast\u2010enhanced ultrasonography demonstrated high diagnostic accuracy in identifying benign testicular lesions, such as Leydig cell tumours; they are the most common non\u2010palpable tumours detected in infertile men and may benefit from enucleation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.13233","type":"journal-article","created":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T13:09:24Z","timestamp":1658063364000},"page":"1387-1397","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Multiparametric ultrasound for the diagnosis of Leydig cell tumours in non\u2010palpable testicular lesions"],"prefix":"10.1111","volume":"10","author":[{"given":"Beniamino","family":"Corcioni","sequence":"first","affiliation":[{"name":"Department of Radiology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0574-3455","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Brandi","sequence":"additional","affiliation":[{"name":"Department of Radiology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna 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