Emergency Ultrasound > Technique
Technique used for Testicular Ultrasound
The patient is asked to undress and lie supine on the examination table and the testicles are elevated with a towel to provide support and ease of scanning. Warm jelly is then applied to the scrotal area and the testicles are scanned with a high frequency linear array transducer, in the range of 7.5 to 10 MHz. Color Doppler and gray scale are both essential during the sonographic study. The examination should always be performed on the normal asymptomatic testis first in order to obtain an overview of the patient's anatomy and to set scanning parameters to be utilized on the abnormal side. These parameters need to be kept equal between both sides to accurately compare differences and asymmetry vital for diagnosis.
It is fundamental to obtain a single image of both testicles side-by-side, in order to demonstrate the gray scale and blood flow differences between the normal and abnormal sides. It is also mandatory to include images of the inguinal canal and both epididymis to exclude abnormalities within these this regions including epididymitis, epididymal cysts or tumors; and varicocele or inguinal hernias along the inguinal canal. When encountering an abnormal mass, differentiation between an intra-parenchymal and an extra-testicular mass is of utmost importance as the differential diagnosis and the patient's prognosis vary accordingly. Most intra-parenchymal masses are malignant while most extra-testicular lesions are of benign origin.
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