:::: MENU ::::
  • Caesarean Section Scar Niche

  • BSMMU Residency Exam Preparation

  • Fetal Intracardiac Echogenic Focus

            

Clinical Features:

A 13-year-old male patient came with

- Severe left hemiscrotal pain for around 4 days

- Scrotal swelling


Ultrasound Features:

- Swollen left testis & epididymis with inhomogeneous parenchymal echotexture. 

- Multiple irregular anechoic spaces within the left testicular parenchyma.

- Color Doppler shows no detectable flow within the left testis & epididymis.

- A lamellated mass with concentric layering just cephalad to the left testis representing the coiled spermatic cord components forming the ‘whirlpool sign’ with twisting or whirling on color Doppler.

- Discrete punctate non-shadowing hyperechoic foci diffusely scattered throughout the testicular parenchyma bilaterally with comet tail artifacts.

- Left sided mild hydrocele with internal non-vascular septations.

- Thickening of the left hemiscrotal skin.


Remember:

- In case of incomplete testicular torsion, color Doppler may show vascularity within the testis.
- An increase in arterial RI of >0.75 & absence of intratesticular venous flow may help confirm testicular torsion.
- Clusters of testicular microliths may represent testicular tumor without soft tissue mass.
- Clusters of microliths adjacent to solid mass suggest a germ cell tumor.


Ultrasound Diagnosis:

- Left testicular early subacute torsion with mild reactionary hydrocele.

- Bilateral diffuse testicular microlithiasis.


Ultrasound Images:




Right testicular diffuse microlithiasis






Swollen left testis & epididymis with inhomogeneous parenchymal echotexture. 
Multiple irregular anechoic spaces within the left testicular parenchyma.
Left testicular diffuse microlithiasis.
Color Doppler shows no detectable flow within the left testis & epididymis.
Left sided mild hydrocele with internal non-vascular septations.



A lamellated mass with concentric layering just cephalad to the left testis representing the coiled spermatic cord components forming the ‘whirlpool sign’ with twisting or whirling on color Doppler.


YouTube Link:

For further demonstration, don't forget to check our video:

YouTube Link







0 comments:

Post a Comment