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Sonography of the Scrotum: Case-Based Review

Joseph W. Stengel1,2 and Erick M. Remer1

1 Section of Abdominal Imaging, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave. – A21, Cleveland, OH 44195.
2 Present address: Department of Radiology, University of California San Francisco, San Francisco, CA 94143.


Figure 1
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  		Fig. 1A —17-year-old boy with acute scrotal pain. Gray-scale transverse sonogram scrotum shows markedly heterogeneous echotexture of left testis.

 

Figure 2
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  		Fig. 1B —17-year-old boy with acute scrotal pain. Sagittal color Doppler sonogram of left testis shows markedly heterogeneous echotexture and lack of flow within the testis.

 

Figure 3
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  		Fig. 2 —51-year-old man with acute left scrotal pain after bowel surgery. Color Doppler sonogram shows focal rounded hypoechoic avascular lesion in superior pole of left testis. Segmental infarction is diagnosis at orchiectomy.

 

Figure 4
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  		Fig. 3A —61-year-old man with scrotal swelling and pain for 2 days. Sagittal (A) and transverse (B) gray-scale sonograms of epididymis show marked epididymal enlargement (A) as well as hypoechogenicity and hydrocele (B). Epididymal enlargement, hypoechogenicity, and hydrocele are seen in both A and B.

 

Figure 5
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  		Fig. 3B —61-year-old man with scrotal swelling and pain for 2 days. Sagittal (A) and transverse (B) gray-scale sonograms of epididymis show marked epididymal enlargement (A) as well as hypoechogenicity and hydrocele (B). Epididymal enlargement, hypoechogenicity, and hydrocele are seen in both A and B.

 

Figure 6
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  		Fig. 3C —61-year-old man with scrotal swelling and pain for 2 days. Color Doppler sonogram shows increased color flow (hyperemia) in epididymis and testis.

 

Figure 7
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  		Fig. 4 —37-year-old man with scrotal pain after trauma. Transverse gray-scale sonogram of right testis shows multiple punctate, nonshadowing, echogenic foci but no intratesticular mass.

 

Figure 8
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  		Fig. 5 —28-year-old man with nontender, palpable right testicular mass. Sagittal gray-scale sonogram shows well-circumscribed mass in testis with hyperechogenic rim and heterogeneous, predominantly sonolucent center. Some acoustic shadowing is seen. No laminations are identified.

 

Figure 9
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  		Fig. 6 —37-year-old man with painless, firm lump adjacent to left testis. Gray-scale sonogram shows mixed-echogenicity mass adjacent to left testis in expected position of epididymis.

 

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