Anna L. Kühn, Eduardo Scortegagna, Kristina M.

Nowitzki,
Young H. Kim
Department of Radiology, UMass Memorial Medical Center,
University of Massachusetts
Medical Center, Worcester, MA, USA

Yodi Wijaya, S.Ked Pembimbing:

G1A216036 dr. Ali Imran Lubis,Sp.Rad
 Ultrasonography is the ideal noninvasive imaging
modality for evaluation of scrotal abnormalities.
 It is capable of differentiating the most important
etiologies of acute scrotal pain and swelling, including
epididymitis and testicular torsion, and is the imaging
modality of choice in acute scrotal trauma
 In most cases of scrotal disease, the combination of
clinical history, physical examination, and information
obtained with ultrasonography is sufficient for
diagnostic decision-making
 Both testicles lie within the scrotum, a
fibromuscular sac divided into the right and
left hemiscrotum by a midline septum
(raphe). The normal male testicle is an ovoid
structure measuring approximately 5×3×2 cm
(length×height×breadth) with a
homogeneous intermediate echogenicity
ultrasonography appearance.
 Ultrasonography of the scrotum includes
greyscale and color Doppler evaluation of
testicles, epididymides, and the scrotum.
 Spectral Doppler evaluation is usually
performed to demonstrate appropriate
waveforms within the testicular artery and
vein.
 Usually, it’s used a high frequency, broad
bandwidth 17-5 MHz or 12-5 MHz transducer
 Acute Scrotal Pain:
Epididymitis, epididymo-orchitis, Orchitis,
Torsion, Cellulitis,Vasitis
 Trauma
hematocele, hematoma and testicular lession
 Palpable Lumps and Incidental Finding
epididymal Cyst, Epidermoid Cyst, Spermatocele,
Varicocele, Hydrocele, Microlithiasis, Scrotolith,
Adenomatoid Tumor, Germ Cell Tumor and Non-
Germ Cell Tumor
  A common cause of acute scrotal pain which is
usually the result of an acute bacterial
infection. Extension of it then termed
Epididymo-Orchytis.

A 48-YEAR-OLD MALE WITH RIGHT

TESTICULAR PAIN AND SWELLING.
 it can occur at any age. Normally, the tunica
vaginalis fixates the posterior aspect of the testicle.
But it has A sensitive and specific sign for torsion is
the so-called real-time whirlpool sign (spiral twist of
the spermatic cord)

A 20-YEAR-OLD MALE WITH

LEFT TESTICULAR PAIN.
THE LEFT TESTICLE SHOWS A
SPERMATIC CORD THAT IS
TWISTED ON ITSELF
 HYDROCELE IN A 28-YEAR-OLD
 A hydrocele is a MALE WITH SCROTAL SWELLING.
TRANSVERSE ULTRASONOGRAM OF
large collection of THE SCROTUM SHOWS AN ANECHOIC
FLUID COLLECTION SURROUNDING
fluid between the THE TESTICLE (ASTERISKS).

visceral and parietal

layers of the tunica
vaginalis and the
most common
cause of painless
scrotal swelling
 Germ cell tumors are approximately 90-95% of all
testicular tumors
 Divide into seminomal and non-seminomal germ
cell tumors
SEMINOMAL NON-SEMINOMAL
INTERNAL VASCULAR FLOW INCREASED INTERNAL VASCULARITY
 Ultrasonography remains the first-line imaging
modality for evaluation of acute or chronic
scrotal diseases. It is a safe and reliable tool for
demonstration of scrotal anatomy, localization
of testicular lesions and assessment of
vascularity. As several testicular pathologies
have characteristic ultrasonographic
appearances,ultrasonography is able to
appropriately guide patient management and
potentially prevent unnecessary surgical
intervention.