Diagnostic Ultrasound - Abdomen and Pelvis
Testes TESTICULAR AND EPIDIDYMAL APPENDAGE Anatomy: Pelvis Testicular appendages Epididymal head Cystic epididymal appendix Epididymal head Torsed epididymal appendix (Top) Longitudinal grayscale ultrasound of the testis in a patient with a hydrocele shows 2 small nodular protuberances from the surface of the testis, isoechoic to normal testicular parenchyma. This is the appendix testis, which is a remnant of the müllerian system. (Middle) Transverse grayscale ultrasound of the epididymal head in a patient with a small hydrocele shows cystic protuberance from the surface of the epididymis. It is isoechoic to normal testicular parenchyma. This is the appendix testis, which is a remnant of the müllerian system. (Bottom) Sagittal color Doppler ultrasound of the left epididymal head shows an exophytically arising heterogeneous lesion without internal vascularity. The patient presented with acute scrotal pain. These findings are suggestive of a torsed epididymal appendix. 137
Testes Anatomy: Pelvis TUNICA VAGINALIS, ALBUGINEA AND VASCULOSA Tunica vaginalis Hydrocele Parietal layer of tunica albuginea Visceral layer of tunica albuginea Testis Tunica vasculosa (Top) Sagittal grayscale ultrasound of the left scrotum shows the outermost serous membrane covering the testis and epididymis, the tunica vaginalis. There is small fluid within the tunica vaginalis (hydrocele). (Middle) Transverse grayscale ultrasound of the right testis shows 2 thin echogenic layers covering the testis, representing the parietal and visceral layers of tunica albuginea, which is the fibrous covering of the testis. (Bottom) Sagittal grayscale ultrasound of the left testis shows the innermost layer covering the outer aspect of the testis and inner aspect of the tunica albuginea, comprising the vascular plexus that is called the tunica vasculosa. 138
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Testes<br />
Anatomy: <strong>Pelvis</strong><br />
TUNICA VAGINALIS, ALBUGINEA AND VASCULOSA<br />
Tunica vaginalis<br />
Hydrocele<br />
Parietal layer of tunica albuginea<br />
Visceral layer of tunica albuginea<br />
Testis<br />
Tunica vasculosa<br />
(Top) Sagittal grayscale ultrasound of the left scrotum shows the outermost serous membrane covering the testis <strong>and</strong> epididymis, the<br />
tunica vaginalis. There is small fluid within the tunica vaginalis (hydrocele). (Middle) Transverse grayscale ultrasound of the right testis<br />
shows 2 thin echogenic layers covering the testis, representing the parietal <strong>and</strong> visceral layers of tunica albuginea, which is the fibrous<br />
covering of the testis. (Bottom) Sagittal grayscale ultrasound of the left testis shows the innermost layer covering the outer aspect of<br />
the testis <strong>and</strong> inner aspect of the tunica albuginea, comprising the vascular plexus that is called the tunica vasculosa.<br />
138
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