Ultrasound: testicular

Anatomy

• testicle - ~2 to 3 cm in width and 3 to 5 cm in length
• epididymis - along the posterolateral aspect of each testis
• vas deferens
• spermatic cord
• median raphe

Technique

• linear transducer
• scanned in longitudinal and transverse axis
• first the unaffected hemiscrotum
• coronal scan showing both testicles side by side (Buddy View) should be performed to identify differences in size and echogenicity, and vascularity
• Power Doppler examination on unaffected side for calibration of machine

Terms

• hyperemia:inflammation and demonstrates no flow and lots of color with out a pulse
  • Think orchitis and detorsed testicle

Findings and DDX

• epididymitis - enlarged epididymis with decreased echogenicity
• orchitis - enlarged testicle with heterogeneous echogenicity with increased blood flow
• hydrocele - Abnormal collection of fluid in the space between the visceral and parietal layers of the tunica vaginalisin anterolateral portions
• varicocele - left side, multiple anechoic serpiginous tubular or curvilinear structures of varying sizes (larger than 2 mm in diameter)
• testicular torsion - power Doppler with absent blood flow in the affected testicle; patient can present early and still have flow
• torsion of the testicular appendage
• testicular trauma
• herniation of abdominal contents into the scrotum - peristalsis of bowel

See Also

• Ultrasound (Main)
• Orchitis
• epididymitis
• hydrocele
• testicular torsion
• varicocele

Source

• Sonosite