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 increased flow (lots of color) compared to contralateral side
  • Think -itis 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 testicular appendage
• Testicular trauma
• Herniation of abdominal contents into the scrotum - peristalsis of bowel

See Also

• Ultrasound (Main)
• Testicular diagnoses

References

• Sonosite - Last Accessed 12/30/14