EURORAD ESR

Case 13299

Segmental infarction of the testis: correlation of conventional and contrast-enhanced ultrasound findings.

Author(s)
Vasileios Rafailidis, Maria E. Sellars, Margarita Nesbitt, Paul S. Sidhu

Department of Radiology, King’s Cοllege Hospital, London, United Kingdom. Email:billraf@hotmail.com
 
Patient
male, 35 year(s)
 
 
  • Figure 1
    Conventional ultrasound with a linear L12-5 MHz transducer
     

    Transverse ultrasound image comparing the two testes. The right testis is enlarged, hypoechoic and heterogeneous compared to the left.

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

    Long-axis ultrasound image over the right testis. The mid and upper aspects are hypoechoic and heterogeneous. The lower pole appears normal.

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

    Colour Doppler technique showing absence of blood flow signals in the upper and mid aspects of the right testis and only minimal flow in the lower pole.

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

    Colour Doppler technique showing thickening and hyperemia of the soft tissues of the right hemiscrotum.

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

    The left testis showed normal blood flow signals on colour Doppler.

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 2
    Contrast-enhanced ultrasound
     

    39 seconds after the microbubble administration there was no enhancement of the hypoechoic part of right testis. The lower pole showed minimal and delayed enhancement (arrowheads).

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound; Procedure: Contrast agent-intravenous; Special Focus: Ischaemia / Infarction;

    CEUS image showing normal enhancement of the left testis.

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound; Procedure: Contrast agent-intravenous; Special Focus: Ischaemia / Infarction;

    64 seconds after microbubble administration there is still no enhancement of the mid and upper pole of the testis and minimal enhancement of the lower pole (arrowheads).

     
    Area of Interest: Genital / Reproductive system male; Imaging Technique: Ultrasound; Procedure: Contrast agent-intravenous; Special Focus: Ischaemia / Infarction;
     
     
Transverse ultrasound image comparing the two testes. The right testis is enlarged, hypoechoic and heterogeneous compared to the left.
 
Long-axis ultrasound image over the right testis. The mid and upper aspects are hypoechoic and heterogeneous. The lower pole appears normal.
 
Colour Doppler technique showing absence of blood flow signals in the upper and mid aspects of the right testis and only minimal flow in the lower pole.
 
Colour Doppler technique showing thickening and hyperemia of the soft tissues of the right hemiscrotum.
 
The left testis showed normal blood flow signals on colour Doppler.
 
39 seconds after the microbubble administration there was no enhancement of the hypoechoic part of right testis. The lower pole showed minimal and delayed enhancement (arrowheads).
 
CEUS image showing normal enhancement of the left testis.
 
64 seconds after microbubble administration there is still no enhancement of the mid and upper pole of the testis and minimal enhancement of the lower pole (arrowheads).
 
 
 
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