Radiologic Findings of Segmental Testicular Infarction

Fernández-Pérez, G. C.; Tardáguila, Francisco; Velasco, María José Martín; Rivas, Celso; Santos, John Dos; Cambronero, J.; Trinidad, Carmen; Miguel, P. San

doi:10.2214/ajr.184.5.01841587

Cited by 134 publications

(125 citation statements)

References 20 publications

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“…Most of the times has an hypoechoic aspect or a mixed echogenicity, it is well defined, has wedge or round shape and decreased or absent vascularity. Segmentary infarction may sometimes raise differential diagnosis issues with a hypovascular tumor [4,18,19]. In these cases, CEUS examination brings additional information regarding the lack of CE within the lesion [4].…”

Section: Figmentioning

confidence: 99%

Contrast enhanced harmonic ultrasonography for the evaluation of acute scrotal pathology. A pictorial essay.

et al. 2016

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Conventional ultrasonographic evaluation (grey scale and Doppler) represents the first line investigation in the acute pathology of the scrotum. Its diagnosis value in acute scrotal pathology is undoubted in regard with hypervascular lesions, but in the evaluation of isoechoic and hypo/avascular lesions i.v. contrast-enhanced harmonic ultrasonography (CEUS) is recommended in establishing a firm and certain diagnosis. Besides these, CEUS has an important role in the evaluation of the remaining viable testicular tissue in cases of testicular trauma, thus guiding a limited excision surgery. This paper aims to discuss the added diagnosis value of CEUS and to illustrate this through various ultrasonographic images suggestive for acute scrotum pathology.

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Section: Figmentioning

confidence: 99%

Contrast enhanced harmonic ultrasonography for the evaluation of acute scrotal pathology. A pictorial essay.

et al. 2016

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“…Predisposing factors to segmental infarction include epididymo-orchitis, trauma, hypersensitivity angiitis, intimal fibroplasia of the testicular artery, previous surgery, polycythaemia and sickle cell disease [11]. Ultrasound examination demonstrates an area of mixed or low reflectivity, which may be wedge or round shaped [12].…”

Section: Segmental Testicular Infarctionmentioning

confidence: 99%

Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis

Huang¹,

Sidhu²

2012

The British Journal of Radiology

120

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ABSTRACT. The aim of this review is to illustrate the potential of different and newer ultrasound techniques beyond conventional B-mode imaging, including colour Doppler ultrasound, contrast-enhanced ultrasound (CEUS) and tissue elastography, in the characterisation of both benign and malignant intratesticular lesions. Normally, testicular malignancies, either primary or secondary, demonstrate an increase in colour Doppler signal. However, there is a diversity of benign testicular lesions that may mimic testicular malignancies. The use of CEUS improves characterisation of testicular lesions, and confirms lack of vascularity in benign abnormalities such as epidermoid cysts, infarctions, abscesses and changes following trauma. Tissue elastography allows further evaluation of the cellular consistency of the abnormality. Familiarity with the appearances seen with these ultrasound techniques in both benign and malignant abnormalities should aid in improving confidence in arriving at the correct diagnosis.

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“…Difficulty arises in the case of small tumors that may also show low flow, thus mimicking a testicular infarct (40)(41)(42). Magnetic resonance imaging (MRI) has been found to be useful in distinguishing tumors from segmental infarcts by demonstrating the presence of an enhancing rim around a segmental infarct as well as the typical wedge shape of an infarct (43).…”

Section: Focal/segmental Testicular Infarctmentioning

confidence: 99%

Non neoplastic intratesticular masses

Bhatt¹,

Jafri²,

Wasserman³

et al. 2009

Diagn Interv Radiol

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High-frequency ultrasonography is the first modality of choice for the evaluation of scrotal pathology. The use of high-frequency ultrasound is increasing, allowing detection and better characterization of many benign intrascrotal lesions that can be treated with non-surgical management or testicular-sparing surgery.This pictorial essay presents gray-scale and color-flow Doppler features of non-neoplastic intratesticular masses. For ease of understanding, the review is organized into three major categories: cystic, vascular, and solid non-neoplastic masses. Table summarizes the key sonographic features, each with recommended management. Sonographic anatomy of the testisThe normal adult testes in each hemi scrotum are symmetric in size and measure approximately 5x3x2 cm. On ultrasound, a normal testis is identified by the presence of homogeneous, medium-level echoes and is contained by a fibrous sheath called the tunica albuginea. The tunica albuginea is identified on ultrasound as a thin echogenic line around the testis and is externally covered by the tunica vaginalis. The tunica vaginalis consists of visceral and parietal layers that are normally separated by a few milliliters (2-3 mL) of fluid. The tunica attaches to the scrotal wall at the posterolateral aspect of the testis. From the posterior aspect of the testis, the tunica albuginea invaginates within the testis to form an incomplete septum, called the mediastinum testis. Sonographically, the mediastinum testis appears as an echogenic band of variable thickness that extends across the testis in the longitudinal axis (Fig. 1). Multiple fibrous septa extend from the mediastinum into the testis, dividing it into 250 to 400 lobules. Spermatogenesis occurs within the seminiferous tubules contained within these lobules. The seminiferous tubules open into dilated spaces called the rete testis within the mediastinum via the tubuli recti. The normal rete testis can be seen on high-frequency US in 18% of patients. (1). The rete testis drains into the epididymis via 10 to 15 efferent ductules.There are four testicular appendages (remnants of the mesonephric and paramesonephric ducts): the appendix testis (hydatid of Morgagni), the appendix epididymis, the vas aberrans, and the paradidymis. The appendix testis and the appendix epididymis are commonly seen on scrotal US. The appendix testis is a small ovoid structure usually at the upper pole of the testis in the groove between the testis and the epididymis, better seen by the presence of fluid around the testis.The testes are supplied by testicular arteries that arise from the abdominal aorta. The testicular arteries enter the spermatic cord at the deep inguinal ring and continue along the posterior surface of the testis, penetrating the tunica albuginea and forming the capsular arteries that course through the tunica vasculosa, which underlies the tunica ABDOMINAL IMAGING PICTORIAL ESSAY Imaging of non-neoplastic intratesticular massesShweta Bhatt, Syed Zafar H. Jafri, Neil Wasserman, Vikram S. Dogra ABSTRACTThe u...

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Radiologic Findings of Segmental Testicular Infarction

Abstract: The presence of a triangular-shaped avascular intratesticular lesion on sonography or MRI and enhancement of the surrounding borders on enhanced MR images may suggest a presurgical diagnosis of segmental testicular infarction and therefore avoid a total orchiectomy in these patients.

Cited by 134 publications

References 20 publications

Contrast enhanced harmonic ultrasonography for the evaluation of acute scrotal pathology. A pictorial essay.

Contrast enhanced harmonic ultrasonography for the evaluation of acute scrotal pathology. A pictorial essay.

Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis

Non neoplastic intratesticular masses

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