segmentaler Hodeninfarkt
Segmental
infarction of the testis: correlation of conventional and contrast-enhanced ultrasound findings.. Transverse ultrasound image comparing the two testes. The right testis is enlarged, hypoechoic and heterogeneous compared to the left.
Segmental
infarction of the testis: correlation of conventional and contrast-enhanced ultrasound findings.. Long-axis ultrasound image over the right testis. The mid and upper aspects are hypoechoic and heterogeneous. The lower pole appears normal.
Segmental
infarction of the testis: correlation of conventional and contrast-enhanced ultrasound findings.. Colour Doppler technique showing absence of blood flow signals in the upper and mid aspects of the right testis and only minimal flow in the lower pole.
Segmental
infarction of the testis: correlation of conventional and contrast-enhanced ultrasound findings.. Colour Doppler technique showing thickening and hyperemia of the soft tissues of the right hemiscrotum.
Segmental
infarction of the testis: correlation of conventional and contrast-enhanced ultrasound findings.. 64 seconds after microbubble administration there is still no enhancement of the mid and upper pole of the testis and minimal enhancement of the lower pole (arrowheads).
Acute scrotal
ultrasound: a practical guide. Acute scrotal pain due to segmental testicular infarction following aortic graft placement. a Longitudinal US image of the testis with shows a geographic region of decreased echogenicity at the superior aspect of the right testis. There was no color Doppler flow shown in this segment. b Corresponding (same patient as in part a) post-contrast T1 weighted image with fat saturation shows lack of enhancement at in a geographic region at the superior pole of the right testis. The findings were presumably due to an embolic event in the peri-procedural period. The patient was treated conservatively and symptoms resolved
A case report
of acute testicular pain secondary to segmental testicular infarction. Ultrasonography was performed after infarction, revealing uneven localized heterogeneous echogenicity with no internal blood flow signal in the upper pole of the left testis, measuring 24 mm * 26 mm (A). The upper part of the left testicle showed an avascular area (B). One week after the infarction, the ultrasound showed that the echogenicity of the upper half of the left testis was reduced, measuring 20 mm * 19 mm (C), and several blood flow signals (D) were seen at its edge. Three weeks after the infarction, the ultrasound showed that the echogenicity of the upper half of the left testis was reduced, measuring 15 mm * 16 mm (E), and several punctate foci with strong echogenicity (F) were observed. Five weeks after infarction, the ultrasound revealed heterogeneous localized echogenicity in the left testis, measuring 14 mm * 15 mm (G), and enhanced signals (H) appeared in the infarct after contrast
A case report
of acute testicular pain secondary to segmental testicular infarction. MR examination of the infarction showed a round lesion in the left testis with mixed-signal intensity (low signal intensity on T1WI, mixed high signal and low signal intensity on T2WI, low signal intensity on DWI, mixed high signal, and low signal intensity on ADC). The lesion was with clear boundary, measuring 22 mm * 19 mm, with ring enhancement at the edge, without obvious enhancement (A, B, C, D). Five weeks later, MR revealed a round lesion in the left testis (mixed high signal and low signal intensity on T1WI and T2WI, high signal intensity in the center, low signal intensity at the edge on DWI, and low signal intensity on ADC). The lesion had a clear boundary, measuring 12 mm*12 mm, with ring enhancement at the edge, without obvious enhancement (E, F, G, H)
A case report
of acute testicular pain secondary to segmental testicular infarction. CT examination after infarction, three-dimensional reconstruction of CT showed a low-density area in the upper part of the left testis, with no obvious enhancement (Fig. 3)
Segmental
testicular infarction • Segmental testicular infarction following epididymo-orchitis - Ganzer Fall bei Radiopaedia
Segmental
testicular infarction • Testicular infarction - segmentary - Ganzer Fall bei Radiopaedia
Segmental
testicular infarction • Testicular infarction - segmentary - Ganzer Fall bei Radiopaedia
Segmental
testicular infarction • Segmental testicular infarction - Ganzer Fall bei Radiopaedia
Segmental testicular infarctions are uncommon testicular lesions that usually result from arterial embolization or thrombosis (as opposed to testicular infarction from torsion, which may originate from venous occlusion).
Pathology
The causes of a segmental testicular infarct include:
- orchitis
- sickle cell disease
- trauma
- pelvic surgery (such as herniorrhaphy)
- vasculitis
Radiographic features
Ultrasound
- focal hypoechoic region in the testis
- wedge-shaped or rounded
- absence of color Doppler flow in the hypoechoic region
Differential diagnosis
The important differential diagnosis for a focal hypoechoic region in the testicle is a testicular neoplasm. A segmental infarct will show decreased color Doppler flow, but this requires scrupulous attention to color Doppler technique. For practical purposes, include both on a differential unless absolutely sure it is not a neoplasm (e.g. it was not present on a study from a couple of days ago).
Also on the differential:
- intratesticular hematoma
- granulomatous disease of the testicle: testicular sarcoidosis, testicular tuberculosis
Siehe auch:
Assoziationen und Differentialdiagnosen zu segmentaler Hodeninfarkt: