Diagnostic Ultrasound - Abdomen and Pelvis

Focal Extratesticular Mass
Differential Diagnoses: Scrotum
(Left) Longitudinal ultrasound
shows a well-circumscribed
cystic lesion ſt in the head of
the epididymis. Note layering
of internal echoes st due to
spermatozoa within the
spermatocele. (Right) Oblique
ultrasound shows a wellcircumscribed
anechoic lesion
ſt in the head of the
epididymis, features
suggestive of a simple
epididymal cyst. Note the
anechoic internal contents
and posterior acoustic
enhancement st.
Spermatocele
Epididymal Cyst
(Left) Oblique ultrasound
shows dilated, tortuous
varicose veins of the
pampiniform plexus ſt in the
spermatic cord, along the
posterosuperior aspect of the
testis, features of a varicocele.
(Right) Oblique color Doppler
ultrasound shows a "torsion
knot" ſt or "whirlpool"
pattern of spermatic cord just
immediately cranial to the
testis , features suggesting
an acute torsion of spermatic
cord. The testis is prone to
infarct due to compromised
vascularity.
Varicocele
Spermatic Cord Torsion
(Left) Hypoechoic
extratesticular hematoma
in a patient with straddle
injury to groin is shown. No
injury to ipsilateral testicle
was seen in this patient.
(Right) This solid, wellcircumscribed
slightly
hyperechoic adenomatoid
tumor in the epididymal tail
st has little internal
vascularity.
Hematoma
Adenomatoid Tumor
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