BENIGN AND MALIGNANT INTRATESTICULAR LESIONS: SONOGRAPHIC FEATURES.

Gray-scale sonography in combination with color Doppler imaging is the imaging modality of choice for evaluating scrotal disease because it delivers excellent spatial resolution and assists in the identification and characterization of scrotal masses. Most Intratesticular lesions usually show hypoechoic, are malignant but benign masses has been reported. The differentiation between malignant and benign lesions is important because the treatment is different. Sonography permits differentiation between intratesticular lesions and extra-testicular lesions. In this article, we review the relevant literature and discuss the sonographic and clinical features of different types of intratesticular hypoechoic masses. Familiarity with the sonographic appearances of benign and malignant testicular lesions may allow specific diagnosis. The patient is scanned in the supine position with a folded towel positioned between the patient's legs to support the scrotum. The penis is positioned over the patient's suprapubic region and draped with a second towel. The scanning is performed with a 5- to 12-MHz linear array transducer. Serial transverse and sagittal images of each testis and epididymis are obtained in addition to at least 1 image showing both testicles for direct comparison of testicular echogenicity, echo texture, and scrotal thickness. Color Doppler sonography is used to assess and document blood flow in the testis. The power level, threshold persistence, and wall filter should adjusted to maximize the detection of blood flow through the field of view. Intratesticular cysts including cysts of the tunica albuginea, tubular ectasia of the rete testis, and testicular cysts. Testicular cysts have the typical appearance of other cysts, well defined anechoic structures with increased through transmission. Tubular ectasia of the rete testis showed as hypoechoic branching cystic configurations in the mediastinum testis. These findings may be associated with a spermatocele in the same size. [ABSTRACT FROM AUTHOR]