EURORAD ESR

Case 13077

The “fountain sign” in a case of idiopathic scrotal oedema, combined with cryptorchidism

Author(s)
Vasileios Rafailidis1, Athanasia Mimila2, Christina Urumowa2, Dimitrios Rafailidis2

1. Radiology Department of AHEPA University Hospital, Thessaloniki, Greece
2. Radiology Department of Gennimatas General Hospital of Thessaloniki, Greece
Email:billraf@hotmail.com
 
Patient
male, 9 year(s)
 
 
  • Figure 1
    Gray scale ultrasonography
     

    Transverse gray scale ultrasonography of the scrotum showing marked homogeneous thickening of the scrotal wall, caused by oedema. The wall measured 9 mm in thickness.

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Acute; Oedema;

    Longitudinal ultrasonography of the scrotum showing the thickened hypoechoic subcutaneous tissues along with an echogenic tunica on the right side.

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Acute; Oedema;
     
     
  • Figure 2
    Ultrasound of a sliding testis on the right side.
     

    In this oblique view the sliding testis was imaged with normal size and echopattern. It is situated inside the inguinal canal.

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Congenital;

    In this longitudinal view the sliding testis was imaged in an intrascrotal position along with mild hydrocele.

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 3
    Cryptorchidism on the left

    Ultrasound showing a normal undescended testis on the left side.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 4
    Power Doppler imaging
     

    Transverse power Doppler image showing thickened, hypoechogenic and hypervascularized scrotal wall.

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound-Power Doppler; Procedure: Diagnostic procedure; Special Focus: Acute;

    Oblique ultrasound image after optimization of blood flow adjustments for detection of slow flow (appropriate threshold settings) showing the increased vascularity within the scrotal skin.

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound-Power Doppler; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 5
    The ultrasonographic “fountain sign”
     

    Transverse colour Doppler image of the scrotum demonstrating increased blood flow signals within the peritesticular scrotal soft tissues. The signal pattern resembles a coloured fountain and is created by the intense...

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Acute;

    Schematic representation of the fountain sign.

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Image manipulation / Reconstruction; Procedure: Education; Special Focus: Acute;
     
     
Transverse gray scale ultrasonography of the scrotum showing marked homogeneous thickening of the scrotal wall, caused by oedema. The wall measured 9 mm in thickness.
 
Longitudinal ultrasonography of the scrotum showing the thickened hypoechoic subcutaneous tissues along with an echogenic tunica on the right side.
 
In this oblique view the sliding testis was imaged with normal size and echopattern. It is situated inside the inguinal canal.
 
In this longitudinal view the sliding testis was imaged in an intrascrotal position along with mild hydrocele.
 
Ultrasound showing a normal undescended testis on the left side.
 
Transverse power Doppler image showing thickened, hypoechogenic and hypervascularized scrotal wall.
 
Oblique ultrasound image after optimization of blood flow adjustments for detection of slow flow (appropriate threshold settings) showing the increased vascularity within the scrotal skin.
 
Transverse colour Doppler image of the scrotum demonstrating increased blood flow signals within the peritesticular scrotal soft tissues. The signal pattern resembles a coloured fountain and is created by the intense hyperaemia (arrow).
 
Schematic representation of the fountain sign.
 
 
 
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