欧洲泌尿生殖放射学会 (ESUR) 的阴囊和阴茎成像工作组 (SPIWG) 旨在就放射科医生在评估男性不育症中的作用提出建议，重点关注阴囊成像。作者独立进行了广泛的文献 Medline 搜索以及对该领域专家的临床实践和共识的回顾。阴囊超声（US）对于调查男性不育症很有用。与异常精子参数（精子浓度、总数、活力和形态）相关的超声异常包括睾丸体积过低（TV）、睾丸不均匀性（TI）、隐睾、睾丸微石症（TML）、高级精索静脉曲张、双侧输精管缺失输精管、双侧扩张和附睾回声纹理异常。因此，ESUR-SPIWG 对评估男性不育症的影像学提出的建议是： 测量 TV；调查 TI；对有隐睾/睾丸固定术病史的男性和/或患有 TML 加“其他危险因素”或患有“星空”TML 的男性进行年度（美国）随访，直至 55 岁；对睾丸不可触及的男性进行阴囊/腹股沟超声检查；对精子参数异常的男性进行阴囊超声检查，以调查提示肿瘤的病变；以标准化方式评估精索静脉曲张；评估是否存在输精管；检查附睾以检测提示梗阻和/或炎症的间接体征。ESUR-SPIWG 建议对不育男性进行阴囊超声检查，重点关注 TV、不均匀性、定位、精索静脉曲张、输精管和附睾异常。应检测与睾丸肿瘤风险相关的隐睾、TML 和病变。ESUR-SPIWG 关于男性不育评估中阴囊成像的建议有助于标准化超声检查，重点关注与精液参数异常相关的超声异常迄今为止，尚无关于阴囊成像评估男性不育症的 ESUR-SPIWG 建议。 ESUR-SPIWG 建议对不育男性进行阴囊超声检查，重点关注睾丸体积、不均匀性、定位、精索静脉曲张、输精管和附睾异常，并评估隐睾、睾丸微石症和与睾丸肿瘤风险相关的病变。 ESUR-SPIWG 关于阴囊成像在男性不育评估中的建议有助于标准化超声检查，以循证方式重点关注与异常精子参数最相关的超声异常，并向患者提供标准化报告。© 2024。作者。

The Scrotal and Penile Imaging Working Group (SPIWG) of the European Society of Urogenital Radiology (ESUR) aimed to produce recommendations on the role of the radiologist in the evaluation of male infertility focused on scrotal imaging.The authors independently performed an extensive literature Medline search and a review of the clinical practice and consensus opinion of experts in the field.Scrotal ultrasound (US) is useful in investigating male infertility. US abnormalities related to abnormal sperm parameters (sperm concentration, total count, motility, and morphology) are low testicular volume (TV), testicular inhomogeneity (TI), cryptorchidism, testicular microlithiasis (TML), high-grade varicocele, bilateral absence of vas deferens, bilateral dilation and echotexture abnormalities of the epididymis. The proposed ESUR-SPIWG recommendations for imaging in the evaluation of male infertility are therefore: to measure TV; investigate TI; perform annual (US) follow-ups up to age 55 in men with a history of cryptorchidism/orchidopexy and/or in men with TML plus "additional risk factors" or with "starry sky" TML; perform scrotal/inguinal US in men with nonpalpable testis; perform scrotal US in men with abnormal sperm parameters to investigate lesions suggestive of tumors; evaluate varicocele in a standardized way; evaluate the presence or absence of vas deferens; investigate the epididymis to detect indirect signs suggesting obstruction and/or inflammation.The ESUR-SPIWG recommends investigating infertile men with scrotal US focusing on TV, inhomogeneity, localization, varicocele, vas deferens, and epididymal abnormalities. Cryptorchidism, TML, and lesions should be detected in relation to the risk of testicular tumors.The ESUR-SPIWG recommendations on scrotal imaging in the assessment of male infertility are useful to standardize the US examination, focus on US abnormalities most associated with abnormal semen parameters in an evidence-based manner, and provide a standardized report to patients.So far, ESUR-SPIWG recommendations on scrotal imaging in the assessment of male infertility were not available. The ESUR-SPIWG recommends investigating infertile men with scrotal US focusing on testicular volume, inhomogeneity, localization, varicocele, vas deferens and epididymal abnormalities, and assessing cryptorchidism, testicular microlithiasis and lesions in relation to the risk of testicular tumors. The ESUR-SPIWG recommendations on scrotal imaging in the assessment of male infertility are useful to standardize the US examination, focus on US abnormalities most associated with abnormal sperm parameters in an evidence-based manner, and provide a standardized report to patients.© 2024. The Author(s).