How to do testicular ultrasound

I believe that many people do not know how to do testicular color Doppler ultrasound, so you can increase your medical knowledge and learn more about related medical articles. In fact, testicular color Doppler ultrasound is the main method to check whether the testicles have orchitis and erectile dysfunction. It mainly observes the normal function of the scrotum and testicles through longitudinal and transverse scanning, and observes the spermatic cord structure connected to the testicles.

There are generally two methods for scrotal ultrasound scanning:

(1) Longitudinal scan: Use the index and thumb of the left hand to properly fix the testicle and perform a longitudinal multi-plane scan to show the ultrasound structure of the testicle, epididymis head and tail, and part of the spermatic cord.

(2) Perform a transverse scan to compare the scrotal skin, testicles, and epididymis to observe the shape, size, and internal echo of the testicles. Observe whether there is fluid in the tunica vaginalis around the testicles and whether there are any abnormal echoes.

Normal value

Normal sonogram of scrotum: There is an oval testicle on each side of the scrotal septum, with a smooth capsule. The light spot inside the testicle is of medium echo and evenly distributed. The epididymis head can be seen above the testicle, with echo similar to that of the testicle, mostly in a triangular shape. The epididymis and tail are located dorsally and below the testicle, with low echo and are easily missed. The normal spermatic cord is not easy to show with two-dimensional ultrasound, but CDFI can show the arterial and venous blood flow signals inside it.

Clinical significance

(1) Ultrasound can help detect small testicular tumors, including local occult cancers (only 2-3 mm) with retroperitoneal metastasis. Ultrasound can also help detect whether patients with testicular tumors have retroperitoneal or hilar lymph node metastases, which is beneficial for clinical staging. Color Doppler ultrasound can improve the ultrasound detection rate or sensitivity of testicular tumors, but it lacks specificity in differentiating from certain inflammatory diseases.

(2) In the case of scrotal trauma, ultrasound examination can help to correctly judge scrotal hematoma and determine whether the testicles are damaged; it can also help to determine the indications for surgical exploration, such as testicular rupture and retained foreign body.

(3) Ultrasound is sensitive and accurate in diagnosing varicocele. The overall sensitivity of CDI can be as high as 100%.

(4) Ultrasound is the preferred method for diagnosing occult testis because it is simple, relatively accurate, non-radioactive and non-invasive. Ultrasound is less sensitive than X-rays and CT scans, and ultrasound examination is often difficult when the testis is located in the peritoneum. If ultrasound scans fail to detect occult testis, "absent testis" should not be diagnosed, and CT scans or surgical exploration are still necessary.

Applicable:

(1) Unexplained scrotal enlargement.

(2) Diagnosis and differentiation of testicular, epididymal and penile masses.

(3) Diagnosis of scrotal and testicular trauma, testicular torsion, and penile trauma.

(4) Varicose vein.

(5) Cryptorchidism.

Notes

Usually the patient lies supine, exposing the lower abdomen and vulva, and uses a treatment towel or tissue to lift the scrotum to the anterior abdominal wall and instruct the patient to fix it with his hands. The standing position is used to examine varicocele and hernia. More coupling agent is needed on the surface of the scrotum to ensure adequate contact between the skin and the probe.

Related diseases

Cryptorchidism, testicular torsion in children, oligospermia, male genital trauma, orchitis, testicular tumor, hydrocele, male infertility, testicular torsion, epididymitis

Related symptoms

Scrotal cold pain, vas deferens pain, vas deferens obstruction, scrotal prolapse, scrotal swelling, ejaculation pain, penile and scrotal edema, hematospermia, body pain, male infertility