Sonographic evaluation of acute intrascrotal pathology.

Berman, Joel M.; Beidle, T R; Kunberger, L E; Letourneau, J G

doi:10.2214/ajr.166.4.8610563

Cited by 43 publications

(33 citation statements)

References 3 publications

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“…In this case, CEUS can facilitate diagnosis by showing a clear difference in the degree of enhancement between the normal and affected side. Similarly, in chronic (missed) torsion, no testis enhancement on CEUS facilitates to interpret weak color Doppler signals when increased vascularity of the peri-testicular tissues occurs (4,12,13). In addition, since CEUS requires no parameter optimization for the detection of slow flow, or flow in small vessels, it may prove easier and faster than color Doppler in the diagnosis of acute testicular torsion (14).…”

Section: Figure 4 -Severe Testicular Trauma A) On Baseline Ultrasounmentioning

confidence: 99%

“…These findings suggest the need for surgical exploration. In contrast, CEUS can confirm or exclude the presence of abscess in cases of serious, persistent inflammation (epididymitis or epididymoorchitis) (12,17). In fact, CEUS findings are diagnostic: epididymal, testicular and scrotal abscesses show a typical strong rim enhancement and non-enhancing contents while enhancing septa may be demonstrated within the lesions (18).…”

Section: Figure 5 -Epididymal Abscess A) Baseline Color Doppler Exammentioning

confidence: 99%

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Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography?

et al. 2009

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Purpose: To present and evaluate the findings of contrast-enhanced ultrasonography (CEUS) in typical cases of acute painful scrotum. Materials and Methods: Nineteen patients aged from 19 to 61 years old were included in the study. All patients underwent grey-scale and color Doppler ultrasonography (US) of the scrotum, followed by imaging after i.v. administration of 2.4 mL of a second generation ultrasound contrast agent (microbubbles of sulphur hexafluoride). Α dedicated, contrast-sensitive technique was used (Contrast Tissue Imaging -CnTI). The diagnosis was confirmed surgically in 6 cases while in the remaining 8 cases it was based on the combination of clinical, imaging and laboratory findings. Results: The final diagnosis was testicular torsion (n = 4), epididymitis (n = 2, one of the cases complicated by abscess), testicular abscess (n = 1), scrotal abscess (n = 1), testicular trauma of varying severity (n = 6). Five out of 19 cases were true negatives: neither clinical examination nor laboratory tests revealed any pathology. CEUS showed complete lack of enhancement in all cases of torsion, permitting a rapid and definitive diagnosis. In the cases of infection complicated by abscesses, CEUS delineated the lesions much better than the combination of B-mode/Color Doppler US. The severely traumatized testicles showed minimal, inhomogeneous or patchy enhancement, while cases of minor trauma showed no significant enhancement defects. Hematomas were presented as non-enhancing lesions. Conclusion: Generally, there was no advantage over Doppler US as has been previously shown. However, CEUS can be used supplementary to traditional Doppler US in the investigation of blunt testicular trauma especially when there is uncertainty in diagnosis after appropriate clinical and radiographic evaluations occurs. Further studies are required to clearly define the indications of this method.

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Section: Figure 4 -Severe Testicular Trauma A) On Baseline Ultrasounmentioning

confidence: 99%

Section: Figure 5 -Epididymal Abscess A) Baseline Color Doppler Exammentioning

confidence: 99%

Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography?

et al. 2009

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“…Epididymal abscesses are an uncommon complication of epididymitis [1] and may develop when epididymitis is severe and goes untreated [2]. Neisseria gonorrhoeae, Chlamydia trachomatis, Escherichia coli, and Proteus mirabilis are common pathogens [3].…”

Section: Discussionmentioning

confidence: 99%

Epididymal abscess in renal transplant: uncommon presentation of Klebsiella septicemia

et al. 2009

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We present a renal allograft recipient 16 months posttransplant with an unusual infectious complication. This gentleman was antihepatitis C virus pretransplant, had a live unrelated transplant, and was taking cyclosporine, mycophenolate mofetil, and prednisolone. He developed diabetes and left scrotal abscess 3 months posttransplant and underwent left orchiectomy. He developed acute right epididymitis progressing to epididymal abscess, septicemia, and acute chronic graft dysfunction. Blood cultures and aspirated pus cultures grew Klebsiella pneumoniae and were treated with intravenous antibiotics, to which he responded. This case highlights an unusual complication in renal transplant and its successful management.

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“…The epididymis can become inflamed and hypoechoic if the deferential artery is involved. 26 Color Doppler US has been shown to be a reliable method of evaluating intratesticular and epididymal blood flow. 10,11,24,27,28 During the evaluation of the acute scrotum, the asymptomatic side should be scanned first to set the gray scale and Doppler gains to facilitate accurate comparison with the injured/painful side.…”

Section: Torsionmentioning

confidence: 99%

Sonographic Findings of Typical and Atypical Scrotal Trauma

Sommers

2015

Ultrasound Quarterly

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This review article illustrates sonographic findings in the setting of accidental and nonaccidental scrotal trauma. Although sonographic findings may be irrespective of the type of trauma, the goals of sonographic evaluation are similar in both atypical and typical mechanisms of scrotal injury. Familiarity with findings such as disruption of testicular integrity or vascularity facilitates prompt diagnosis and plays a critical role in clinical management.

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Sonographic evaluation of acute intrascrotal pathology.

Cited by 43 publications

References 3 publications

Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography?

Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography?

Epididymal abscess in renal transplant: uncommon presentation of Klebsiella septicemia

Sonographic Findings of Typical and Atypical Scrotal Trauma

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