Scrotal collections: pictorial essay correlating sonographic with magnetic resonance imaging findings

Abstract

The present study is aimed at describing scrotal collections observed at ultrasonography and magnetic resonance imaging. The authors describe the main features of hydrocele, hematocele and pyocele, as well as the most common causes, clinical manifestations and associated diseases, with a brief review of the embryology and anatomy of the scrotum. Collections are frequently found in the evaluation of the scrotum, which is often performed on an emergency basis, and in most cases can be differentiated by means of imaging studies. With the consolidation of magnetic resonance imaging as the method of choice complementary with ultrasonography, the authors also describe magnetic resonance imaging findings of scrotal collections as well as the situations where such method is indicated.

Ultrasound evaluation of inguinoscrotal pain: an imaging-based review for the ultrasonographer

“…Although the clinical history is often sufficient for making the diagnosis, ultrasound plays a central role in the evaluation of suspected testicular rupture and is indicated if there is a break in the continuity of the testicular surface, which is demarcated by the tunica albuginea. In all cases of blunt force testicular trauma, ultrasound is indicated ( 7 ) . If the tunica albuginea is not intact, surgery should be performed promptly in order to save the organ.…”

“…The same applies if there is extruded material or loss of testicular homogeneity ( 8 , 9 ) , as depicted in Figure 10 . Ultrasound is also crucial in the follow-up of cases of trauma with hematocele, because blood collections can lead to a pressure increase within the tunica, generating ischemic injury and subsequent testicular atrophy ( 7 , 10 ) , as well as increasing the risk of subsequent infection.…”

Ultrasound imaging of acute scrotum: Pictorial review with etiological correlation

“…Hydrocele is an abnormal collection of serous fluid accumulating between the visceral and parietal layers of the tunica vaginalis. It occurs in up to 25% of all major cases of trauma and hydrocele can also be seen in acute scrotal pathologies like epididymo-orchitis, torsion and neoplasms [5]. On US, hydrocele appears as an anechoic fluid collection surrounding the anterolateral aspects of the testis.…”

Sliding inguinoscrotal hernia insinuating itself into the bladder, with calculi in the bladder and distal ureter

“…Magnetic resonance imaging can be used in place of CT. The combination of ultrasound and magnetic resonance imaging is useful for the noninvasive, nonradiative evaluation of alterations in the scrotum ( 8 ) .…”