1
|
Lotti F, Bertolotto M, Maggi M. Historical trends for the standards in scrotal ultrasonography: What was, what is and what will be normal. Andrology 2021; 9:1331-1355. [PMID: 34089245 DOI: 10.1111/andr.13062] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Ultrasonography is the gold standard imaging method for scrotal investigation. Colour Doppler ultrasonography, contrast-enhanced ultrasonography and sonoelastography allow sonographers to assess size, echotexture, vascular features and stiffness of the scrotal organs and abnormalities. Scrotal ultrasonography has been used to investigate male reproductive health, scrotal pain, masses and trauma. However, ultrasonography thresholds/classifications used to distinguish normal and pathologic features of the scrotal organs have changed over time, and have not yet been fully standardized. OBJECTIVES To evaluate historical trends for the standards in scrotal ultrasonography: what was, what is and what will be normal. METHODS An extensive Medline search was performed identifying the most relevant studies in the English language from inception to date. RESULTS We provide here (i) a brief overview of the history of ultrasonography, (ii) current indications for scrotal ultrasonography and (iii) previous and current normal values, cut-offs and classifications of the main colour-Doppler ultrasonography parameters/characteristics of the scrotal organs, as derived from recent guidelines and evidence-based studies. In addition, we report recommendations and the clinical utility of contrast-enhanced ultrasonography and sonoelastography. Finally, we discuss critical issues needing further evidence and future directions to fill in the current gaps. DISCUSSION Several studies on scrotal ultrasonography are available. However, guidelines/recommendations dealing with specific ultrasonography applications have been published only in recent years. More recently, the European Academy of Andrology published evidence-based scrotal colour-Doppler ultrasonography reference ranges/normative parameters derived from a cohort of healthy, fertile men. In addition, a standardization of the methodology to evaluate qualitative and quantitative colour-Doppler ultrasonography parameters was reported. Other international societies reported indications, methodological standards, clinical utility and limitations of contrast-enhanced ultrasonography and sonoelastography. CONCLUSIONS To date, colour-Doppler ultrasonography normative values for the scrotal organs are available. However, a wide international consensus on assessment and classification of several ultrasonography parameters is still lacking. An alignment of the world societies on these issues is advocated.
Collapse
Affiliation(s)
- Francesco Lotti
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Michele Bertolotto
- Department of Radiology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| |
Collapse
|
2
|
Intratesticular abscess in a solitary testicle: the case for testicle sparing management. Case Rep Med 2013; 2013:184064. [PMID: 24198833 PMCID: PMC3809365 DOI: 10.1155/2013/184064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 09/04/2013] [Indexed: 11/18/2022] Open
Abstract
We present the case of a 24-year-old immunocompromised man with an intratesticular abscess. The patient presented with one week of left scrotal pain and swelling. Workup included scrotal ultrasonography which revealed a large fluid collection within the tunica albuginea of the left testis. Surgical exploration of the left testis evacuated a significant amount of purulent fluid. The residual viable testicular parenchyma was salvaged. Intraoperative cultures grew Morganella morganii. Follow-up ultrasonography showed resolution of the testicular fluid collection, and the patient was discharged home with oral antibiotics. Intratesticular abscesses are a rare clinical entity which often result in orchiectomy.
Collapse
|
3
|
[Non palpable testicular tumors. Retrospective series]. Prog Urol 2013; 24:46-50. [PMID: 24365628 DOI: 10.1016/j.purol.2013.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/20/2013] [Accepted: 06/03/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To report our experience in 13 cases with nonpalpable testicular tumors and review the literature. MATERIAL AND METHODS From 1998 to 2012, 13 patients were diagnosed with nonpalpable testicular tumors. The data base was performed prospectively, and analyzed retrospectively. We evaluated demographic data, clinical presentation, ultrasound tumor features, tumor markers, frozen and final histopathological findings. All patients were also evaluated with serum tumor markers and the surgical approach was inguinal. RESULTS The mean age was 46.4 years and the most frequent clinical presentation were orchialgia in six patients (46.1%) and infertility in three (23%). All masses were hypoechoic with an average tumor size of 8.9 mm. The serum tumor markers were negative in all patients and the final histopathological findings were six seminomas, two embryonal carcinomas, one seminiferous tubules atrophy, a segmental testicular infarction, a Sertoli cell tumor and a Leydig cell tumor. CONCLUSIONS Nonpalpable testicular masses were benign in almost half of the cases; therefore, we recommend using the frozen section pathology as a tool to perform conservative surgery in selective cases.
Collapse
|
4
|
Jeyakumar S, De AK, Kundu A, Roy K, Sunder J, Kundu M, Balakrishnan M, Chand S, Ahmed SZ. Sonographic characteristics of goat testis on water bath based ultrasonography. Livest Sci 2013. [DOI: 10.1016/j.livsci.2012.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
5
|
Geraghty MJ, Lee FT, Bernsten SA, Gilchrist K, Pozniak MA, Yandow DJ. Sonography of Testicular Tumors and Tumor-Like Conditions: A Radiologic-Pathologic Correlation. ACTA ACUST UNITED AC 2011. [DOI: 10.3109/10408379891244163] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
6
|
Gotto GT, Chang SD, Nigro MK. MRI in the diagnosis of incomplete testicular torsion. Br J Radiol 2010; 83:e105-7. [PMID: 20418466 DOI: 10.1259/bjr/95900989] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We present a case of subacute left testicular pain and enlargement. Scrotal Doppler ultrasound revealed an enlarged left testicle with symmetrical intra-testicular colour flow bilaterally. Contrast-enhanced MRI demonstrated incomplete testicular torsion which was verified at surgery. To our knowledge, this is the first report on the use of contrast-enhanced MRI in the diagnosis of incomplete testicular torsion.
Collapse
Affiliation(s)
- G T Gotto
- Department of Urologic Sciences, University of British Columbia, Vancouver, Canada
| | | | | |
Collapse
|
7
|
KRAUSE D, RATH D. Untersuchungen zur Anwendbarkeit der Sonographie in der veterinär-andrologischen Diagnostik. Andrologia 2009. [DOI: 10.1111/j.1439-0272.1987.tb02341.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
8
|
|
9
|
Sheynkin YR, Sukkarieh T, Lipke M, Cohen HL, Schulsinger DA. Management of nonpalpable testicular tumors. Urology 2004; 63:1163-7; discussion 1167. [PMID: 15183972 DOI: 10.1016/j.urology.2003.12.054] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2003] [Accepted: 12/17/2003] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To report our series of nonpalpable testicular tumors with a review of published studies. Radical orchiectomy remains the reference standard in the treatment of a solid testicular mass. Testis-sparing surgery has recently been advocated for a select group of patients with nonpalpable tumors. METHODS Between 1998 and 2002, a nonpalpable testicular mass was discovered in 9 patients. Ultrasonography was performed for infertility evaluation (5 patients), testicular pain (3 patients), and retroperitoneal lymphadenopathy (1 patient). RESULTS Radical orchiectomy was performed in 7 of 9 patients and testis-sparing surgery with microsurgical excision of tumor in 1 patient. One patient decided against surgery. A benign testicular tumor was found in 6 and a malignant tumor in 2 of the 8 patients. CONCLUSIONS A high incidence of benign nonpalpable tumor and an advanced microsurgical technique justifies organ-sparing surgery as an alternative for radical orchiectomy in a select group of patients. Testicular preservation in patients with a malignant nonpalpable testicular tumor is a feasible, but still controversial, approach.
Collapse
Affiliation(s)
- Yefim R Sheynkin
- Department ofUrology, Health Science Center, State University of New York at Stony Brook, Stony Brook, New York 11794-8093, USA
| | | | | | | | | |
Collapse
|
10
|
Gouletsou PG, Amiridis GS, Cripps PJ, Lainas T, Deligiannis K, Saratsis P, Fthenakis GC. Ultrasonographic appearance of clinically healthy testicles and epididymides of rams. Theriogenology 2003; 59:1959-72. [PMID: 12600733 DOI: 10.1016/s0093-691x(02)01259-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The clinically healthy testicles and epididymides of 31 rams were imaged inside and outside the breeding period, by using a real time ultrasound scanner. A scanning technique based on multiple imaging planes from the caudal and the lateral surface of the genitalia was employed. Optimum imaging was achieved by using a 6.0 MHz frequency sector transducer. The testicular parenchyma appeared homogeneous with a coarse medium echo-pattern. The mediastinum testis was present in 87% of rams and 77% of testicles; its median echogenicity score was 2 (range: 0-3) among rams aged 13 months or older and 1 among rams aged less than 13 months (P = 0.001). The tail of the epididymis was always clearly visible; it appeared less echoic than the testicular parenchyma and with a heterogeneous structure. The epididymal body was not visible, whilst the epididymal head was consistently partially imaged. The pampiniform plexus was clearly imaged as a dome-shaped structure masking the upper part of the head of the epididymis. The scrotal septum was seen in lateral sonograms as a highly echogenic line between the testicles. The scrotal skin formed a thick hyper-echoic peripheral structure.
Collapse
Affiliation(s)
- P G Gouletsou
- Veterinary Faculty, University of Thessaly, PO Box 199, GR-43100 Karditsa, Greece.
| | | | | | | | | | | | | |
Collapse
|
11
|
Muglia V, Tucci S, Elias J, Trad CS, Bilbey J, Cooperberg PL. Magnetic resonance imaging of scrotal diseases: when it makes the difference. Urology 2002; 59:419-23. [PMID: 11880084 DOI: 10.1016/s0090-4295(01)01579-5] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To investigate the utility of magnetic resonance imaging (MRI) after inconclusive sonography in the evaluation of scrotal disease. METHODS From 1993 to 1999, 622 patients underwent ultrasonography (US) with state-of-the-art equipment to evaluate scrotal diseases. Twenty-six patients, two with bilateral and distinct diseases (age range 1--63 years, mean 33), had an inconclusive sonogram and were sent for MRI. The MRI results were compared with previous US reports and with the final diagnosis. RESULTS MRI yielded additional and correct information (compared with US), coincident with the final diagnosis in 23 cases (82.1%). In regard to lesions suspected of malignancy at US (17 cases), MRI had a great concordance with the final diagnosis and was statistically significant (P <0.002, kappa test). CONCLUSIONS The results of our study indicate that MRI could help elucidate scrotal dilemmas found at US, although the small percentage of inconclusive sonograms confirms this technique as the first choice when imaging is required in scrotal diseases.
Collapse
Affiliation(s)
- Valdair Muglia
- Department of Radiology, University of São Paulo, Ribeirão Preto, School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | | | | | | | | | | |
Collapse
|
12
|
Szmigielski W, Khairat M, Haider A, Ejeckam GC. Huge scrotal lipoma masquerading as haematoma. Clin Radiol 2000; 55:479-80. [PMID: 10873696 DOI: 10.1053/crad.2000.0090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- W Szmigielski
- Department of Radiology, Hamad General Hospital, Doha, State of Qatar
| | | | | | | |
Collapse
|
13
|
|
14
|
Abstract
The early and accurate diagnosis of testicular torsion remains a clinical challenge. The implications of a missed diagnosis have emphasized the need for a non-invasive test for confirming testicular ischaemia; a problem highlighted by difficulties in establishing the diagnosis clinically. Understandably, the advent of colour Doppler ultrasound (CDUS) (and subsequently 'power' Doppler and microbubble ultrasound contrast), has been greeted with enthusiasm. However, as in other fields of medicine, a policy placing sole reliance on a single technique is likely to be flawed. This review will critically evaluate the role of CDUS and other imaging modalities in the diagnosis of testicular torsion.
Collapse
Affiliation(s)
- P S Sidhu
- Department of Diagnostic Radiology, Kings College Hospital, Denmark Hill, London, UK
| |
Collapse
|
15
|
Sakai N, Yamada T, Asao T, Murayama T. Sonographically-detected impalpable testicular cancer with retroperitoneal bulky metastases: a case report. Int J Urol 1997; 4:533-4. [PMID: 9354963 DOI: 10.1111/j.1442-2042.1997.tb00302.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report a case of a sonographically-detected impalpable embryonal cell carcinoma with bulky retroperitoneal metastases. A 34-year-old man, who presented with left flank pain, was presumed to have an extragonadal retroperitoneal germ cell tumor. Scrotal sonography revealed a hypoechoic lesion, 7 mm in diameter, which was histologically diagnosed as a primary embryonal cell carcinoma. Evidence suggested that the primary tumor had grown slowly, as the tumor was well encapsulated. This case suggests that some extragonadal germ cell tumors arise from a primary testicular cancers, and that successful treatment of these tumors should include consideration that they may have arisen as a primary testicular mass.
Collapse
Affiliation(s)
- N Sakai
- Department of Urology, Sagamihara National Hospital, Japan
| | | | | | | |
Collapse
|
16
|
|
17
|
Comiter CV, Renshaw AA, Benson CB, Loughlin KR. Burned-Out Primary Testicular Cancer: Sonographic and Pathological Characteristics. J Urol 1996. [DOI: 10.1016/s0022-5347(01)65947-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Craig V. Comiter
- Division of Urology, Departments of Surgery, Pathology and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew A. Renshaw
- Division of Urology, Departments of Surgery, Pathology and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Carol B. Benson
- Division of Urology, Departments of Surgery, Pathology and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kevin R. Loughlin
- Division of Urology, Departments of Surgery, Pathology and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
18
|
Shen HJ, Gueng MK, Wu CJ, Huang GS, Wang J, Chou TY. Ultrasonographic findings in scrotal filarial elephantiasis. JOURNAL OF CLINICAL ULTRASOUND : JCU 1995; 23:561-563. [PMID: 8537481 DOI: 10.1002/jcu.1870230911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- H J Shen
- Department of Diagnostic Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | | | | | | | | | | |
Collapse
|
19
|
|
20
|
Comiter CV, Benson CJ, Capelouto CC, Kantoff P, Shulman L, Richie JP, Loughlin KR. Nonpalpable Intratesticular Masses Detected Sonographically. J Urol 1995. [DOI: 10.1016/s0022-5347(01)66865-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Craig V. Comiter
- Division of Urology, Departments of Surgery and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Carol J. Benson
- Division of Urology, Departments of Surgery and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Carl C. Capelouto
- Division of Urology, Departments of Surgery and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Philip Kantoff
- Division of Urology, Departments of Surgery and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lawrence Shulman
- Division of Urology, Departments of Surgery and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jerome P. Richie
- Division of Urology, Departments of Surgery and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kevin R. Loughlin
- Division of Urology, Departments of Surgery and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
21
|
Pryor JL, Watson LR, Day DL, Abbitt PL, Howards SS, Gonzalez R, Reinberg Y. Scrotal ultrasound for evaluation of subacute testicular torsion: sonographic findings and adverse clinical implications. J Urol 1994; 151:693-7. [PMID: 8308985 DOI: 10.1016/s0022-5347(17)35051-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
There is an increased use of scrotal ultrasound in the clinician's office and emergency room for the investigation of scrotal pain. The use of real-time scrotal ultrasound for the diagnosis of testicular torsion has been described in the literature. A false-negative ultrasound examination can postpone the diagnosis of torsion and result in testicular loss. We examined 6 patients 1 day to 18 years old who had subacute testicular torsion with scrotal symptomatology (pain and/or swelling) for longer than 8 hours (range 12 hours to 6 days). Scrotal ultrasound was performed as 1 of the initial tests. A common sonographic pattern was an inhomogeneous testicle with hypoechoic areas alternating with hyperechoic areas and thickening of adjacent scrotal tissue. Another common finding was an edematous hyperechoic epididymis and a small hydrocele. In 4 of the 6 cases these nonspecific findings suggested a misleading diagnosis of tumor or epididymitis and resulted in delay of surgery and testicular loss. Treatment was not delayed in only 2 patients in whom the diagnosis of torsion was made initially by history and physical examination, and ultrasound was done for interest only. Misdiagnosis of intratesticular blood flow and some potential pitfalls of scrotal imaging by color Doppler ultrasound are discussed. We conclude that real-time scrotal sonography can be misleading in cases of subacute testicular torsion and, therefore, it should not be used in this clinical setting.
Collapse
Affiliation(s)
- J L Pryor
- Department of Urologic Surgery, University of Minnesota, Minneapolis
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
The technique of renal time ultrasound of the scrotum is described. The examination was performed in 50 patients and 15 normal males at the Sahinbey Hospital. Given the clinical diagnosis ultrasound proved reliable in almost all cases. In this study ultrasonography of the scrotum has been found to be the most useful method demonstrating testicular diseases.
Collapse
Affiliation(s)
- F Yağci
- Department of Urology, University of Gaziantep, School of Medicine, Turkey
| | | | | |
Collapse
|
23
|
Kim SH, Pollack HM, Cho KS, Pollack MS, Han MC. Tuberculous epididymitis and epididymo-orchitis: sonographic findings. J Urol 1993; 150:81-4. [PMID: 8510282 DOI: 10.1016/s0022-5347(17)35404-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The findings at scrotal sonography in 10 patients with tuberculous epididymitis and in 2 with nontuberculous epididymitis are presented. In 6 patients with tuberculous epididymitis the testes were also involved (epididymo-orchitis). The most notable sonographic findings of tuberculous epididymitis were an enlarged epididymis, predominantly in the tail portion, and marked heterogeneity of the echo texture of the involved epididymis. Sonographic findings of associated testicular involvement consisted of a diffusely enlarged hypoechoic testis or ill defined focal intratesticular hypoechoic areas, or an irregular margin between the testis and epididymis. The sonographic findings encountered in patients with tuberculous epididymitis appear to be different from those encountered in nontuberculous epididymitis. Sonography might prove helpful in aiding the clinical distinction between these 2 forms of epididymitis and in demonstrating associated testicular involvement in tuberculous epididymitis.
Collapse
Affiliation(s)
- S H Kim
- Department of Radiology, Seoul National University College of Medicine, Korea
| | | | | | | | | |
Collapse
|
24
|
England GCW. Relationship between ultrasonographic appearance, testicular size, spermatozoal output and testicular lesions in the dog. J Small Anim Pract 1991. [DOI: 10.1111/j.1748-5827.1991.tb00936.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
Johnston GR, Feeney DA, Rivers B, Walter PA. Diagnostic imaging of the male canine reproductive organs. Methods and limitations. Vet Clin North Am Small Anim Pract 1991; 21:553-89. [PMID: 1858249 DOI: 10.1016/s0195-5616(91)50061-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Survey radiographic, contrast radiographic, and ultrasonographic techniques for evaluation of the male canine reproductive organs are reviewed. The applications and limitations of these technique as they apply to reproductive diseases involving the prostate gland and testicles are illustrated.
Collapse
Affiliation(s)
- G R Johnston
- Department of Small Animal Clinical Sciences, University of Minnesota College of Veterinary Medicine, St. Paul
| | | | | | | |
Collapse
|
26
|
Lutzker LG, Zuckier LS. Testicular scanning and other applications of radionuclide imaging of the genital tract. Semin Nucl Med 1990; 20:159-88. [PMID: 2184523 DOI: 10.1016/s0001-2998(05)80168-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The major application of nuclear imaging techniques to the genital tract is pertechnetate scintigraphy for evaluation of the acute hemiscrotum. Within a few years of the first descriptions of scrotal imaging, this technique achieved recognition as a valuable, even indispensable, emergency diagnostic procedure in this context; its validity has since been well confirmed in hundreds of reported cases. Because it is an established procedure with widely recognized applications, its discussion will occupy most of this article. Other nuclear procedures, less widely used either because they are investigative or applicable to smaller patient populations, will be more briefly described.
Collapse
Affiliation(s)
- L G Lutzker
- Department of Radiology, St. Barnabas Medical Center, Livingston, NJ 07039
| | | |
Collapse
|
27
|
Buckspan MB, Klotz PG, Goldfinger M, Stoll S, Fernandes B. Intraoperative ultrasound in the conservative resection of testicular neoplasms. J Urol 1989; 141:326-7. [PMID: 2643723 DOI: 10.1016/s0022-5347(17)40756-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In a series of approximately 400 patients investigated for oligospermia 4 had small testicular tumors demonstrated by high resolution real-time ultrasound. The lesions ranged in size from 3 to 6 mm., were clinically impalpable and were demonstrated on repeated sonograms. Exploration was done in all 4 patients with the aid of intraoperative high resolution ultrasound. This procedure allowed for conservative resection of the tumor with preservation of the testicle. The pathological diagnosis in all cases was benign Leydig cell tumor.
Collapse
Affiliation(s)
- M B Buckspan
- Department of Urology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | | | | | | | | |
Collapse
|
28
|
Abstract
Surface coil magnetic resonance (MR) imaging of the scrotum allows differentiation of the testis, epididymis, and spermatic cord. Intratesticular and extratesticular lesions are demarcated by the tunica albuginea. The sensitivity of MR is very high for detection of scrotal abnormalities but is non-specific since it is unable to distinguish primary testicular tumors from benign lesions. Undescended testes which lie proximal and distal to the internal inguinal ring are well visualized by MR imaging. The advantages of MR imaging in locating undescended testes is that it is noninvasive, without ionizing radiation, and capable of multiplanar images.
Collapse
Affiliation(s)
- P J Fritzsche
- Department of Radiology, School of Medicine, Loma Linda University, California, 92354
| |
Collapse
|
29
|
Abstract
A case is presented of a patient with bilateral cysts of the tunica albuginea. An orchiectomy had been accomplished on the right side, with confirmation of cysts of the tunica albuginea. Cysts of the contralateral testicle were diagnosed by testicular ultrasound examination. This case represents the first reported instance of bilateral cysts of the tunica albuginea.
Collapse
Affiliation(s)
- J F Redman
- Department of Urology, University of Arkansas College of Medicine, Little Rock
| | | |
Collapse
|
30
|
Benelli R, Gavazzi M, Balloni F, Marzocco M, Nannini R, Tenti S, Pedaccini P, Francalanci R, Paoletti G. Ecografia Del Testicolo Neoplastico: Nostra Esperienza. Urologia 1988. [DOI: 10.1177/039156038805500413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | - R. Nannini
- Istituto di Anatomia Patologica di Prato
| | - S. Tenti
- Unità Operativa di Urologia di Arezzo
| | | | | | | |
Collapse
|
31
|
Seguin DR, Longmaid HE. Sonographic Appearance of Testicular Choriocarcinomas. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 1987. [DOI: 10.1177/875647938700300502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Dennis R. Seguin
- Department of Diagnostic Radiology, Ultrasound Department, Dartmouth-Hitchcock Medical Center, Hanover, NH 03756
| | - H. Esterbrook Longmaid
- Department of Diagnostic Radiology, Ultrasound Department, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire
| |
Collapse
|
32
|
Rockey KE, Cusack TJ. Ultrasound imaging of the scrotum. A pictorial guide to its varied capabilities. Postgrad Med 1987; 82:219-27. [PMID: 2885819 DOI: 10.1080/00325481.1987.11699910] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
33
|
Abstract
We reviewed 8 cases of surgically proved testicular abscess with emphasis upon the ultrasonographic findings. The images were correlated with testicular anatomy and the pathological findings of abscess formation. In 3 of 8 patients undergoing serial high resolution ultrasound examinations a consistent pattern of testicular abscess was present 1 to 7 weeks preoperatively. In the remaining 5 patients preoperative ultrasound documented the presence of abscess. Recognition of the ultrasonographic appearance of testicular abscess should permit expedient surgical intervention.
Collapse
|
34
|
Desai KM, Gingell JC, Haworth JM. Localised intratesticular abscess complicating epididymo-orchitis: the use of scrotal ultrasonography in diagnosis and management. BMJ : BRITISH MEDICAL JOURNAL 1986; 292:1361-2. [PMID: 3085847 PMCID: PMC1340369 DOI: 10.1136/bmj.292.6532.1361-a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
35
|
Scott RF, Bayliss AP, Calder JF, Garvie WH. Indications for ultrasound in the evaluation of the pathological scrotum. BRITISH JOURNAL OF UROLOGY 1986; 58:178-82. [PMID: 3516298 DOI: 10.1111/j.1464-410x.1986.tb09022.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Scrotal ultrasound scans carried out on 156 patients were reviewed in a retrospective study and the sonographic findings and indications evaluated. Ultrasound was able accurately to distinguish the normal from the pathological scrotum. Extratesticular lesions were readily differentiated from testicular lesions. Abnormal testicular echo patterns were usually associated with tumours, but orchitis, granulomas and haematomas were found to have a similar appearance. Occult testicular tumours could readily be identified. Ultrasound was also useful in excluding underlying pathology in hydroceles, in the diagnosis and follow-up of epididymitis and other epididymal lesions and in the assessment of underlying testicular damage in traumatic haematoceles. Ultrasound may also be useful in post-orchiectomy follow-up examinations to exclude tumour in the contralateral testis.
Collapse
|
36
|
Tackett RE, Ling D, Catalona WJ, Melson GL. High resolution sonography in diagnosing testicular neoplasms: clinical significance of false positive scans. J Urol 1986; 135:494-6. [PMID: 3511298 DOI: 10.1016/s0022-5347(17)45702-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We describe the use of high resolution real-time ultrasound to evaluate scrotal masses. From August 1980 to September 1984, 249 patients underwent scrotal ultrasound using high resolution real-time scanners with 10 mHz. transducers to evaluate scrotal abnormalities. The ultrasound diagnosis was consistent with a testicular neoplasm in 20 patients. Pathological and surgical confirmation was available in all 20 patients. Only 10 of 20 patients had malignant tumors, whereas 10 had benign lesions (false positive rate of 50 per cent). Testicular lesions producing false positive studies were principally hypoechoic in 8 patients and hyperechoic in 2. Testicular neoplasms characteristically were hypoechoic with or without focal hyperechoic areas. There was 1 false negative ultrasound study. Our results suggest that radical orchiectomy should not be performed indiscriminately in all patients with testicular lesions that are sonographically suspicious for neoplasm. In selected cases with hyperechoic sonographic features associated frequently with benign testis lesions open testicular biopsy and a testis-sparing operation may be indicated.
Collapse
|
37
|
Sanchez S, Mahlin M. Simultaneous bilateral testicular tumors, one side clinically occult: detection by ultrasonography. J Urol 1986; 135:591-2. [PMID: 3511301 DOI: 10.1016/s0022-5347(17)45749-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The majority of bilateral testicular tumors are discovered sequentially. Some of these second tumors may be present subclinically at the time the initial contralateral tumor is diagnosed and their simultaneous detection with ultrasound screening would obviate the inherent problems of an otherwise sequential bilaterality. We report a case of simultaneous bilateral seminomas in which 1 of the 2 tumors was subclinical and detected with ultrasound. The various problems encountered with these asynchronous second tumors in contrast to those diagnosed simultaneously are discussed.
Collapse
|
38
|
Abstract
Scrotal abnormalities are difficult to assess using clinical criteria alone. Ultrasound provides an accurate means of demonstrating the scrotal contents so that appropriate therapy may be instituted. In a retrospective study, 119 ultrasound examinations of 96 patients (aged 4 days to 23 years) have been compared with the clinical diagnosis, surgical/pathologic findings, and other imaging modalities. The gamut of disease identified included congenital anomalies, neoplasm, trauma, torsion, varicocele, hydrocele, epididymo-orchitis, epididymal cyst/spermatocele, and post-radiation fibrosis. The ultrasound findings correlated well in 93/96 patients. In inconclusive cases, sequential imaging helps differentiate traumatic and inflammatory lesions from neoplastic processes.
Collapse
|
39
|
DiGiacinto TM, Clark H, Willscher M, Conway J. False-Positive Sonography of Solid Testicular Lesions. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 1986. [DOI: 10.1177/875647938600200103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors have retrospectively analyzed and correlated with surgery the solid testicular ultrasound findings of 43 patients and review five false-positive cases.
Collapse
Affiliation(s)
- Thomas M. DiGiacinto
- Department of Diagnostic Radiology, Elliot Hospital, 955 Auburn St., Manchester, NH 03103; Department of Diagnostic Imaging, Division of Ultrasound, Elliot Hospital, Manchester, New Hampshire
| | - Heidi Clark
- Department of Diagnostic Imaging, Division of Ultrasound, Elliot Hospital, Manchester, New Hampshire
| | | | - James Conway
- Department of Surgery, Division of Urology; Department of Diagnostic Imaging, Division of Ultrasound, Elliot Hospital, Manchester, New Hampshire
| |
Collapse
|
40
|
Abstract
Ultrasound has emerged as the diagnostic imaging modality of choice in the evaluation of patients with scrotal trauma. Most studies of testicular rupture show great accuracy with virtually no instances of false-positive or false-negative diagnoses. Ultrasonography is capable of differentiating between scrotal hematoma, extratesticular fluid collections, posttraumatic torsion testis, posttraumatic epididymitis, epididymal hematoma, as well as testicular rupture. The differentiation of hematocele from pyocele or exudative hydrocele is generally not possible. In patients with suspected testicular rupture, an accurate diagnosis followed by prompt surgical repair is the key to preservation of testicular function. Ultrasound is an extremely useful adjunct to the physical examination in cases of blunt scrotal trauma both for the differential diagnosis of the enlarged scrotum and for determining the necessity for emergency surgery.
Collapse
|
41
|
Fournier GR, Laing FC, Jeffrey RB, McAninch JW. High resolution scrotal ultrasonography: a highly sensitive but nonspecific diagnostic technique. J Urol 1985; 134:490-3. [PMID: 3897576 DOI: 10.1016/s0022-5347(17)47255-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We compared surgical and pathological findings to those of preoperative scrotal ultrasonography in 50 consecutive patients undergoing surgical exploration for testicular trauma, tumors or benign atraumatic conditions. An inhomogeneous parenchymal echo pattern was the single most reliable predictor of a parenchymal abnormality. Large scrotal hematomas may preclude adequate visualization of the parenchyma and early testicular torsion may exhibit a normal parenchymal echo pattern. Except for early torsion, no false negative predictions of the state of the parenchyma were made.
Collapse
|
42
|
Michell MJ, Thompson PM, Bell AJ, Pryor JP, Packham DA. Ultrasound examination of the scrotum. BRITISH JOURNAL OF UROLOGY 1985; 57:346-50. [PMID: 3891007 DOI: 10.1111/j.1464-410x.1985.tb06359.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The technique of real time ultrasound examination of the scrotum is described. The examination was performed on 120 patients and was found to be a helpful diagnostic aid in scrotal swelling and in the acute painful scrotum. It is recommended as a useful investigation for scrotal abnormalities.
Collapse
|
43
|
|
44
|
|
45
|
|
46
|
Rifkin MD, Kurtz AB, Pasto ME, Rubenstein JB, Cole-Beuglet C, Baltarowich O, Goldberg BB. The sonographic diagnosis of focal and diffuse infiltrating intrascrotal lesions. UROLOGIC RADIOLOGY 1984; 6:20-6. [PMID: 6702026 DOI: 10.1007/bf02923693] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Thirty-six examples of inflammatory and neoplastic disease of the scrotum were evaluated with ultrasound. Analysis of the images suggests that sonographic differentiation of these conditions is possible in certain instances. The ability to separate testicular from extratesticular pathology is quite accurate. In some cases, neoplastic disease of the testis can be differentiated from malignancy, although surgical intervention is often required for diagnosis.
Collapse
|
47
|
Hubbard AE, Ayers AB, MacDonald LM, James CE. In utero torsion of the testis: antenatal and postnatal ultrasonic appearances. Br J Radiol 1984; 57:644-6. [PMID: 6733411 DOI: 10.1259/0007-1285-57-679-644] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
|
48
|
Gavant ML, Smith WC, Parks FD. Ultrasonic evaluation of gun shot injury to testicle. JOURNAL OF CLINICAL ULTRASOUND : JCU 1984; 12:355-356. [PMID: 6438164 DOI: 10.1002/jcu.1870120609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
|
49
|
Nativ O, Graif M, Goldwasser B, Engelberg SI, Itzchak Y. Rhabdomyosarcoma of the cord: ultrasonic evaluation. UROLOGIC RADIOLOGY 1983; 5:131-2. [PMID: 6612917 DOI: 10.1007/bf02926787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A rare case of paratesticular rhabdomyosarcoma in a young adult is described, emphasizing the role of ultrasonic preoperative examination in evaluating the consistency and extension of the scrotal mass for surgical management.
Collapse
|
50
|
Forsberg L, Olsson AM. Examination of the pathological scrotum with dynamic and static ultrasound. Br J Radiol 1983; 56:921-4. [PMID: 6652413 DOI: 10.1259/0007-1285-56-672-921] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Ultrasound examination was performed on 51 patients with clinically pathological scrotum who all underwent surgery. Twenty patients had extratesticular disease and 31 patients had intratesticular disease. The disease was located correctly by ultrasound in all cases. It was, however, not possible to tell a malignant from a benign lesion, or a teratoma from a seminoma. A combination of contact scanning with direct palpation of the lesion and scanning through a water bath or similar "stand-off' arrangement is recommended.
Collapse
|