Abstract
Cross-sectional imaging modalities have greatly improved the diagnosis of scrotal disease. In the clinical evaluation of scrotal abnormalities, physical examination may be difficult and inadequate because of severe pain, tenderness, swelling, and marked distortion of the inner contents of the scrotum. Currently, high-resolution ultrasonography is the imaging modality of choice because of its excellent depiction of scrotal anatomy, low cost, short examination time, and lack of ionizing radiation (Leopold et al. 1979; Carroll and Gross 1983; Hricak and Filly 1983; Krone and Carroll 1985; Benson et al. 1989; O’Mara and Rifkin 1991). Color Doppler has added both anatomic and functional details relevant to the evaluation of the testis and its surrounding structures (Middleton and Melson 1989; Burks et al. 1990; Krieger et al. 1990; Lerner et al. 1990; Middleton et al. 1990; Horstman et al. 1991a,b).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Amelar RD, Dubin L (1973) Male infertility: current diagnosis and treatment. Urology 1: 1 - 31
Arcadia J A (1952) Cysts of the tunica albuginea testis. J Urol 68: 631 - 635
Aristizabal S, Davis JR, Miller RC et al. (1978) Bilateral primary germ cell testicular tumors: report of four cases and review of the literature. Cancer 42: 591
Atkinson GO Jr, Patrick LE, Ball TI Jr, Stephenson CA, Broecker BH, Woodard JR (1992) The normal and abnormal scrotum in children: evaluation with color Doppler sonography. AJR 158: 613 - 617
Baker LL, Hajek PC, Burkhard TK, et al. (1987a) Magnetic resonance imaging of the scrotum: normal anatomy. Radiology 163: 89 - 92
Baker LL, Hajek PC, Burkhard TK et al. (1987b) Magnetic resonance imaging of the scrotum: pathologic conditions. Radiology 163: 93 - 98
Baker LL, Hajek PC, Burkhard TK, Mattrey RF (1987c) Poly orchidism: evaluation by MR. AJR 148: 305 - 306
Batata MA, Whitmore WF Jr, Hilaris BS et al. (1980) Cryptorchidism and testicular cancer. J Urol 124: 382
Belker AM (1981) The varicocele and male infertility. Urol Clin North Am 8: 41 - 51
Ben Chaim J, Leibovitch I, Ramon J, Winberg D, Goldwasser B (1992) Etiology of acute scrotum at surgical exploration in children, adolescents and adults. Eur Urol 21: 45 - 47
Benson CB, Doubilet PM, Richie JP (1989) Sonography of the male genital tract. AJR 153: 705 - 713
Berger Y, Srinivas V, Hajdu SI, Herr HW (1985) Epidermoid cysts of the testis: role of conservative surgery. J Urol 134: 962 - 963
Bird K, Rosenfield AT (1984) Testicular infarction secondary to acute inflammatory disease: demonstration by B-scan ultrasound. Radiology 152: 785 - 788
Bird K, Rosenfield AT, Taylor KJW (1979) Ultrasonography in testicular torsion. Radiology 147: 527 - 543
Brenner JS, Cumming WA, Ros PR (1989) Testicular epidermoid cyst: sonographic and MR findings. AJR 152: 1344
Brown DL, Benson CB, Doherty FJ et al. (1992) Cystic testicular mass caused by dilated rete testis: sonographic findings in 31 cases. AJR 158: 1257 - 1259
Burks DD, Markey BJ, Burkhard TK, Balsara ZN, Haluszka HM, Canning DA (1990) Suspected testicular torsion and ischemia: evaluation with color Doppler sonography. Radiology 175: 815 - 821
Burney B, Klatte E (1979) Ultrasound and computed tomography of the abdomen in the staging and management of testicular carcinoma. Radiology 132: 415 - 419
Caldwell WL, Kudemian MT, Frias Z et al. (1980) The management of testicular seminomas. Cancer 45 [Suppl]: 1768 - 1774
Cardigan P (1989) Polyorchidism diagnosed by ultrasound. Br J Radiol 62: 82 - 83
Carroll BA, Gross DM (1983) High frequency scrotal sonography. AJR 140: 511 - 515
Chen DCP, Holder L, Melloul M (1983a) Radionuclide scrotal imaging: further experience with 210 patients. Part I. Anatomy, pathology and methods. J Nucl Med 24: 735-742
Cho KS, Auh YH, Lee MG, Choi HY, Lee SG, Ahn HJ (1991) Testicular tumor: conventional MR imaging and Gd-DTPA enhancement. In: Book of abstracts, 77th scientific assembly and annual meeting. Radiology 181 [Suppl]: 115
Cho KS, Semba CP, Trambert MA, Mattrey RF (1993) Torsion of the testicular appendages assessed with magnetic resonance imaging. JMR
Clarke BG (1966) Incidence of varicocele in normal men and among men of different age. JAMA 198: 1121 - 1122
Cohen HL, Shapiro MA, Haller JO, Glassberg K (1992) Torsion of the testicular appendage sonographic diagnosis. J Ultrasound Med 11: 81 - 83
Cour-Palar IJ (1966) Spontaneous descent of the testicle. Lancet 1: 430
Dewire DM, Begun FP, Lawson RK, Fitzgerald S, Foley WD (1992) Color Doppler ultrasonography in the evaluation of the acute scrotum. J Urol 147: 89 - 91
Emory TH, Charboneau JW, Randall RV, Scheithauer BW, Grantham JG (1984) Occult testicular interstitialcell tumor in patients with gynecomastia: ultrasonic detection. Radiology 151: 474
Fakhry J, Khoury A, Barakat K (1989) The hypoechoic band: a normal finding on testicular sonography. AJR 153: 321 - 323
Feld R, Middleton WD (1992) Recent advances in sonography of the testis and scrotum. Radiol Clin North Am 30: 1033 - 1051
Finkelstein MS, Rosenberg HK, Snyder HM, Duckett JW (1986) Ultrasound evaluation of the scrotum in pediatrics. Urology 27: 1 - 9
Fornage BD, Touche DH, Rifkin MD (1984) Small parts real-time sonography: a new “waterpath.” J Ultrasound Med 3: 355 - 357
Friedland GW, Chang P (1988) The role of imaging in the management of impalpable undescended testis. AJR 151: 1107 - 1111
Fritzsche PJ, Hricak H, Kogan BA et al. (1987) Undescended testis: value of MRI. Radiology 164: 169 - 173
Fritzsche PJ, Rifkin M, Hopkins CR, Piccoli CW (1992) Scrotum and testis. In: Stark DD, Bradley WG (eds) Magnetic resonance imaging, 2nd edn. Mosby Year Book, St. Louis, pp 2058 - 2079
Gialason T, Noronha RFX, Gregory JG (1980) Acute epididymitis in boys: a 5 year retrospective study. J Urol 124: 533 - 534
Glazer HS, Lee JKT, Melson GL, McClennan BL (1982) Sonographic detection of occult testicular neoplasms. AJR 138: 673 - 675
Glickman MF, Weiss RM, Itzchak Y (1977) Testicular venography for undescended testes. AJR 129: 67 - 70
Goldberg RM, Chilcote W, Kay R, Bodie B (1987) Sonographic findings in polyorchidism. J Clin Ultrasound 15: 412 - 415
Gonda RL, Karo JJ, Forte RA, O’Donell KT (1986) Diagnosis of subclinical varicocele in infertility. AJR 184: 71 - 75
Gooding GAW, Leonhardt W, Stein R (1987) Testicular cysts: US findings. Radiology 163: 537-538
Grantham JG, Charboneau JW, Janes EM et al. (1985) Testicular neoplasm: 29 tumors studied by highresolution US. Radiology 157: 775 - 780
Grechi G, Zampi GC, Selli C, Carini M, Ucci M (1980) Polyorchidism and seminoma in a child. J Urol 123: 291 - 292
Green JR (1985) Computerized axial tomography vs spermatic venography in localization of the cryptorchid testis. Urology 26: 513 - 517
Greenberg SH (1977) Varicocele and male fertility. Fertil Steril 28: 699 - 706
Gullenwater JY, Grayhack JT, Howards SS, Duckett JW (1987) Adult and pediatric urology. Year Book Medical, Chicago, pp 1955 - 1962
Hadziselimovic F (1983) Cryptorchidism. Springer, Berlin Heidelberg New York
Hamm B, Fobbe F, Sorensen R, Felsenberg D (1986) Varicoceles: combined sonography and thermographyReferences
Hamm B, Fobbe F, Sorensen R, Felsenberg D (1986) Varicoceles: combined sonography and thermographyReferences
c; essity to sedate boys less than 8 years of age (When compared to ultrasonography, the advantages of MRI are I in diagnosis and post therapeutic evaluation. Radiology 160:419-424
Hamm B, Frobbe F, Loy V (1988) Testicular cysts: differentiation with US and clinical findings. Radiology 168: 19 - 23
Hancock RA, Hodgins TE (1984) Polyorchidism. Urology 24: 303 - 307
Harrison RG, Barkeley AT (1948) The distribution of the testicular artery (internal spermatic artery) to the human testis. Br J Urol 2: 57 - 66
Hayward I, Trambert MA, Mattrey RF, Saltzstein SL, Demby AM (1990) Case report: MR imaging of vasculitis of the testis. J Comput Assist Tomogr 15: 502-504
Holder L, Melloul M, Chen DCP (1981) Current status of radionuclide scrotal imaging. Semin Nucl Med 11: 232 - 249
Horstman WG, Middleton WD, Melson GL, Siegel BA (1991a) Color Doppler US of the scrotum. Radiographics 11: 941 - 957
Horstman WG, Middleton WD, Melson GL et al. (1991b) Scrotal inflammatory disease: color Doppler US findings. Radiology 179: 55 - 59
Hricak H, Filly RA (1983) Sonography of the scrotum. Invest Radiol 18: 112 - 121
Hricak H, Jeffrey RB (1983) Sonography of acute scrotal abnormalities. Radiol Clin North Am 21: 595 - 603
Hubbard AE, Ayers AB, MacDonald LM, James CE (1984) In utero torsion of the testis: antenatal and postnatal ultrasonic appearance. Br J Radiol 57: 644 - 646
Hutschenreiter G, Alken P, Schneider H (1979) The value of sonography and lymphography in the detection of retroperitoneal metastases in testicular tumor. J Urol 122: 766 - 769
Janzen DL, Mathieson JR, Marsh JI, Cooperberg PL, del Rio P, Golding RH, Rifkin MD (1992) Testicular microlithiasis: sonographic and clinical features. AJR 158: 1057 - 1060
Johnson JO, Mattrey RF, Philpson J (1990) Differentiation of seminomatous from nonseminomatous testicular tumors with MR imaging. AJR 154: 539 - 543
Just M, Melchior S, Grebe P, Kreitner KF, Burger RA, Hohenfellner R, Thelen M (1992) MR tomography in testicular processes. The significance of Gd-DTPA enhanced sequence in comparison with plain T2-weighted sequences. ROFO 166: 527 - 531
Kier R, McCarthy S, Rosenfield AT et al. (1988) Nonpalpable testes in young boys: evaluation with MR imaging. Radiology 169: 429 - 433
Kirschling RJ, Kvols LK, Charboneau JW, Grantham JG, Zincke H (1983) High-resolution ultrasonographic and pathologic abnormalities of germ cell tumors in patients with clinically normal testes. Mayo Clin Proc 58: 648 - 653
Klepp O, Olsson AM, Ous S, Nilsson S, Hoisaether PA, Tveter K (1991) Early clinical stages of nonseminomatous testis cancer. Evaluation of the primary treatment and follow-up procedures of the SWENOTECA project. Scand J Urol Nephrol 25: 179-190
Krieger JN, Wang K, Mack L (1990) Preliminary evaluation of color Doppler imaging for investigation of intrascrotal pathology. J Urol 144: 904 - 907
Krone KD, Carroll BA (1985) Scrotal ultrasound. Radiol Clin North Am 23: 121 - 139
Landa HM, Gylys-Morin V, Mattrey RF et al. (1987) MRI of the cryptorchid testis. Eur J Pediatr 146 [Suppl]: S16 - S17
Landa HM, Gylys-Morin V, Mattrey RF et al. (1988) Detection of testicular torsion by magnetic resonance imaging in a rat model. J Urol 140: 1178 - 1180
Lee JKT, Glazer HS (1982) Computed tomography in the localization of the nonpalpable testis. Urol Clin North Am 9: 397 - 404
Leopold GR, Woo VL, Scheible FW et al. (1979) High resolution ultrasonography of scrotal pathology. Radiology 131: 719 - 722
Lerner RM, Mevorach RA, Hulbert WC, Rabinowitz R (1990) Color Doppler US in the evaluation of acute scrotal disease. Radiology 176: 355 - 358
Leung ML, Gooding GAW, Williams RD (1984) Highresolution sonography of scrotal contents in asymptomatic subjects. AJR 143: 161 - 164
Lupetin AR, King W, Rich P, Lederman RB (1983a) Ultrasound diagnosis of testicular leukemia. Radiology 146: 171 - 172
Lupetin AR, King W, Rich PJ, Lederman RB (1983b) The traumatized scrotum. Radiology 148: 203 - 207
Martin B, Conte J (1987) Ultrasonography of the acute scrotum. J Clin Ultrasound 15: 37 - 44
Mattrey RF (1991) Magnetic resonance imaging of the scrotum. Semin Ultrasound CT MR 12: 95 - 108
Mattrey R, Trambert M (1990) MR imaging of the scrotum and testis. In: Edelman RR, Hesselink JR, Newhouse J, Sartoris DJ (eds) Clinical magnetic resonance imaging. W.B. Saunders, Philadelphia, pp 952 - 979
Maxwell AJ, Mamtora H (1990) Sonographic appearance of epidermoid cyst of the testis. J Clin Ultrasound 18: 188 - 190
McConnell JD, Peters PC, Lewis SE (1982) Testicular rupture in blunt scrotal trauma: review of 15 cases with recent application of testicular scanning. J Urol 128: 309 - 311
Meiches MD, Nurenberg P (1991) Sonographic appearance of a calcified simple epidermoid cyst of the testis. J Clin Ultrasound 19: 498 - 500
Mennemeyer RP, Mason JT (1979) Non-neoplastic cystic lesions of the tunica albuginea: an electron microscopic and clinical study of 2 cases. J Urol 121: 373 - 375
Middleton WD, Melson GL (1989) Testicular ischemia: color Doppler sonographic findings in five patients. AJR 152: 1237 - 1239
Middleton WD, Siegel BA, Melson GL, Yates CK, Andriole GL (1990) Acute scrotal disorders: prospective comparison of color Doppler US and testicular scintigraphy. Radiology 177: 177 - 181
Mittemeyer BT, Lennox KW, Borski AA (1966) Epididymitis: a review of 10 cases. J Urol 95: 390 - 392
Moore KL (1988) The urogenital system. In: The developing human. Clinical oriented embryology, 4th edn. W.B. Saunders, Philadelphia, pp 246 - 285
O’mara EM, Rifkin MD (1991) Scrotum and contents. In: Resnick MI, Rifkin MD (eds) Ultrasonography of the urinary tract, 3rd edn. William and Wilkins, Baltimore, pp 386 - 435
Petros JA, Andriole GL, Middleton WD, Picus DD (1991) Correlation of testicular color Doppler ultrasound, physical examination, and venography in the detection of left varicocele in men with infertility. J Urol 145: 785 - 788
Phillips G, Kumari-Subaiya S, Swaitsky A (1983) Ultrasonic evaluation of the scrotum in lymphoproliferative disease. J Ultrasound 6: 169 - 175
Pillari G, Rubenstein WA, Siess J (1980) Seminoma: improved imaging and tumor characterization with computed tomography. J Urol 123: 41 - 43
Pinch L, Aceto T Jr, Myer-Bahlburg HFL (1974) Cryptorchidism. A pediatric review. Urol Clin North Am 1: 573-592
Rajfer J (1992) Congenital anomalies of the testis. In: Walsh PC, Retik AB, Stamey TA, Vaughan ED Jr (eds) Campbell’s urology, 6th edn. W.B. Saunders, Philadelphia, pp 1543 - 1562
Ralls PW, Larsen D, Johnson MB, Lee KP (1991) Color Doppler sonography of the scrotum Semin Ultrasound CT MR 12: 109 - 114
Rao KG (1980) Traumatic rupture of the testis. Urology 20: 624 - 625
Rholl KS, Lee JKT, Ling D et al. (1987) MR imaging of the scrotum with a high resolution surface coil. Radiology 163: 99 - 103
Richie JP (1992) Neoplasms of the testis. In: Walsh PC, Retik AB, Stamey TA, Vaughan ED Jr (eds) Campbell’s urology. W.B. Saunders, Philadelphia, pp 1222 - 1263
Rifkin MD, Kurtz AB, Pasto ME, Goldberg BB (1983) Polyorchidism diagnosed preoperatively by ultrasonography. J Ultrasound Med 2: 93 - 94
Rifkin MD, Kurtz AB, Pasto ME et al. (1984) The sonographic diagnosis of focal and diffuse infiltrative infracostal lesions. Urol Radiol 6: 20 - 26
Rogers WF, Ralls PW, Boswell WD (1980) Obstruction of the inferior vena cava by seminoma. J Urol 124: 613 - 614
Rolnick D, Kowanous S, Szanto P, Bush IM (1968) Anatomical incidence of testicular appendages. J Urol 100: 775 - 766
Ryan PC, Whelan CA, Gaffney EF, Fitzpatrick JM (1988) The effect of unilateral experimental testicular torsion on spermatogenesis and fertility. Br J Urol 62: 359 - 366
Sadler TW (1990) Urogenital system. In: Langman’s medical embryology, 6th edn. William and Wilkins, Baltimore, pp 260 - 296
Schultz Lampel D, Bogaert G, Thuroff JW, Schlegel E, Cramer B (1991) MRI for evaluation of scrotal pathology. Urol Res 19: 289 - 292
Schwerk WB, Schwerk WN, Rodeck G (1983) Testicular tumors: prospective analysis of real-time US patterns and abdominal staging. Radiology 151: 369 - 374
Scorer CG, Farrington GH (1972) Congenital deformities of the testis and epididymis Appleton-Century-Crofts, New York
Scott RF, Bayliss AP, Calder JF, Gravie WH (1986) Indications for ultrasound in the evaluation of the pathological scrotum. Br J Urol 58: 178 - 182
Seidenwurm D, Smathers RL, Lo RK et al. (1987) Testes and scrotum: MR imaging at 1.5T. Radiology 164: 393 - 398
Shah KH, Maxted WC, Chun B (1981) Epidermoid cysts of the testis: a report of three cases and an analysis of 141 cases from the world literature. Cancer 47: 577 - 582
Shah SN, Miller BM, Geisler E (1992) Polyorchidism discovered as testicular torsion. Urology 39: 543 - 544
Shawker TH, Nasser J, O’leary T et al. (1983) Ultrasonographic detection of “burned-out” primary testicular germ cell tumors in clinically normal testes. J Ultrasound Med 2: 477 - 479
Singer BR, Donaldson JG, Jackson DS (1992) Polyorchidism: functional classification and management strategy. Urology 39: 384 - 388
Smith WS, Brammer HM, Henry M, Frazier H (1991) Testicular microlithiasis: sonographic features with pathologic correlation. AJR 157: 1003 - 1004
Sokal M, Peckham MJ, Hendry WF (1980) Bilateral germ cell tumours of the testis. Br J Urol 53: 158
Tanagho EA (1992) Anatomy of the lower urinary tract. In: Walsh PC, Retik AB, Stamey TA, Vaughan ED Jr (eds) Campbell’s urology, 6th edn. W.B. Saunders, Philadelphia, pp 40 - 69
Tartar VM, Trambert MA, Balsara ZN, Mattrey RF (1993) Tubular ectasia of the testicle: sonographic and MR imaging appearance. AJR 160: 539 - 542
Thum G (1991) Polyorchidism: case report and review of literature. J Urol 145: 370 - 372
Thurner S, Hricak H, Carroll PR et al. (1988) Imaging the testis: comparison between MR imaging and US. Radiology 167: 631 - 636
Trainer TD (1987) Histology of the normal testis. Am J Surg Pathol 11: 797 - 809
Trambert MA, Mattrey RF, Levine D, Berthoty D (1990) Subacute scrotal pain: evaluation of torsion versus epididymitis with MR imaging. Radiology 175: 53 - 56
Vick CW, Bird KI Jr, Rosenfield AT et al. (1982) Ultrasound of the scrotal contents. Radiology 144: 147 - 153
Vick CW, Bird K, Rosenfield A et al. (1986) Extratesticular hemorrhage associated with torsion of the spermatic cord: sonographic demonstration. Radiology 158: 401 - 404
Vordermark JS II, Favila MO (1982) Testicular necrosis: a preventable complication of epididymitis. J Urol 128: 1322 - 1324
Wechsler H, Westfall M, Lattimer JK (1960) The earliest signs and symptoms in 127 male patients with genitourinary tuberculosis. J Urol 83: 801 - 803
Weingarten BJ, Kellman GM, Middleton WD, Gross ML (1992) Tubular ectasia within the mediastinum testis. J Ultrasound Med 11: 349 - 353
Weiss RM, Carter AR, Rosenfield AT (1986) High resolution real-time ultrasonography in the localization of the undescended testis. J Urol 135: 936 - 938
Weiss AJ, Kellman GM, Middleton WD, Kirkemo A (1992) Intratesticular varicocele: sonographic findings in two patients. AJR 158: 1061 - 1063
William R, Feiberg S, Kneight L, Traley E (1980) Abdominal staging of testicular tumors using ultrasonography and computed tomography. J Urol 123: 872 - 875
Williamson RCN, Anderson JB (1986) The fate of the human testes following unilateral torsion. Br J Urol 58: 698 - 704
Wolveson MK, Houttin E, Heiberh E et al. (1983) Comparison of CT with high resolution ultrasound in the localization of the undescended testis. Radiology 146: 133 - 136
Zafaranloo S, Gerard PS, Wise G (1986) Bilateral neonatal testicular torsion: ultrasonographic evaluation. J Urol 135: 589 - 590
Zerin JM, DiPietro MA, Grignon A, Shea D (1990) Testicular infarction in the newborn: ultrasound findings. Pediatr Radiol 20: 329 - 300
Ziffer JA, Nelson RC, Chezmar JL et al. (1989) Subclinical varicoceles: detection with MRI (abstract). Presented at SMRI Los Angeles. Magn Reson Imaging 7 [Suppl]: 78
Zoeller G, Ringert RH (1991) Color-coded duplex sonography for diagnosis of testicular torsion. J Urol 146: 1288 – 1290
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1994 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Cho, K.S., Hsu, B., Mattrey, R.F. (1994). Testis and Scrotum. In: Lang, E.K. (eds) Radiology of the Lower Urinary Tract. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84431-7_17
Download citation
DOI: https://doi.org/10.1007/978-3-642-84431-7_17
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-84433-1
Online ISBN: 978-3-642-84431-7
eBook Packages: Springer Book Archive