Deciphering the ultrasound of the scrotum. Ultrasound of the organs and vessels of the scrotum: norms, interpretation, how a Doppler study is done. Frequent pathological changes

To study the organs located in the scrotum, ultrasound of the vessels of the testicles is prescribed. This is a safe method that eliminates radiation and invasiveness. This procedure evaluates the speed and direction of blood flow, the presence of blood clots, pathologies, the state of the lumen of the vessels and refers to an additional method for examining the male genital organ.

Method characteristic

The Doppler principle is the basis of ultrasound of the scrotum organs with Dopplerography. With the help of this study, a sound wave is measured, the frequency of the signal is determined and mathematical processing is performed. UZDG assesses the condition of the blood vessels, determines the presence of pathologies of the organs located in the scrotum, what capacity the vessels have. Often, to obtain a complete picture, blood flow is measured in an erection.

The ultrasound machine, which is equipped with a doppler, has the following types:

Color flow is based on the color representation of blood flow. The most commonly used colors are red and blue.
ED allows you to evaluate the picture of what is happening due to color shades, their brightness, intensity.
The ID evaluates the blood flow velocity using an acoustic signal.

When shown

Doppler ultrasound is used when a benign or malignant lesion is suspected. However, there are other indications for research: varicocele, testicular torsion, injuries resulting from trauma or blows. With these pathologies, ultrasound not only evaluates blood flow, but also helps to identify the causes that provoked them.

Often, a child is examined in the presence of an acute stage of the disease. It is the only way that gives maximum information and allows you to determine the therapeutic regimen.

pain in the scrotum, swelling, which indicate the presence of an inflammatory process;
enlarged scrotum, which indicates the presence of an infectious disease, hernia, hydrocele;
tumor process, palpable and visible to the ordinary eye;
infertility;
obstruction of the connecting channel;
injuries;
undescended testis.

If during an ultrasound scan the doctor does not receive the necessary information, then the patient may be assigned an additional examination, for example, a color Doppler study

What shows

Many men are interested in the question of what the ultrasound of the scrotum shows. During this survey, the following information is obtained:

how many testicles are in the scrotum;
How are the testicles located?
whether there is liquid in the shells and what is its amount;
testicle shapes;
echostructure of the study area;
the size of the appendages;
blood flow condition.

In a healthy person, the testicles should be in the scrotum. However, there are also the following phenomena: one or two testicles not lowered into the scrotum, the location of the testicle near the base of the penis, on the femoral part, pubis, testicular torsion, which is characterized by the presence of the upper pole in the lower part, the location of the epididymis in front of the testicle. Its normal location is behind the organ.

Carrying out the procedure

Ultrasound diagnostics do not require special preparatory measures. Research can be done at any time. Preparation for ultrasound claims that three days before the diagnosis, it is necessary to exclude the use of any alcoholic beverages, the day before - coffee, strong tea, drugs that affect blood pressure. In addition, it is important to carry out hygienic treatment of the penis, do not take liquid for 3 hours. It is recommended to visit the toilet half an hour before the procedure.

During the procedure, the doctor guides the area under study with an ultrasound probe.

This procedure is completely painless, takes place within 20 minutes. During the study, the patient lies on the couch on his back or side, freeing the lower part of the body from clothing. It may also be necessary to change the position of the body, the examination can be carried out while standing. A gel that conducts electromagnetic waves is applied to the research area. During ultrasound, the following pelvic organs are diagnosed:

testicles;
prostate;
seminal vesicles;
penis;
scrotum;
vas deferens;
prostate.

Norm

Deciphering the ultrasound first of all shows the shape of the testicles. In a healthy man, the testicles are round or oval in shape. The testicles can be represented by an altered shape, which is elongated, unilaterally enlarged. If the ultrasound norm is rejected, then this may be a sign of an inflammatory process, oncological disease, or injury. Contours and dimensions are also important.

Increased size, altered contour may indicate oncology, torsion, orchitis. A decrease in size indicates atrophy, hypoplasia, malnutrition. Violation of the echostructure is a sign of cystosis, abscess, hematomas. These pathologies are characterized by heterogeneity of the echostructure. The indicators of the norm of a man are:

testes from 3 to 5 cm long, from 2 to 3 cm wide, with a homogeneous echostructure, without the presence of formations, with even and clear edges;
appendages - the size of the head is not less than 10 mm, the tail and body should not be visible, without the presence of formations, with a homogeneous echostructure;
scrotum - thickness no more than 8 mm, without the presence of formations, with a homogeneous echostructure;
free fluid should be present in a volume of 1 to 2 mm, with a homogeneous echo structure.

Diagnosis of pathology is carried out both in childhood and in adulthood.

Doppler also allows you to analyze the following indicators:

structures of cavernous bodies, which should have a diameter of 3 to 5 mm with a homogeneous echo structure, without the presence of inclusions;
the onset of an erection should have a terminal velocity of 35 cm/s/8 cm/s. Young patients may have readings of 100 cm/s/20 cm/s. In this case, an increase in the diameter of the cavernous body up to 10 mm occurs;
in the rigid phase, there is a decrease in speeds. However, the peak speed should not be lower than 30 cm/s. A lower number indicates erectile dysfunction;
the difference in the size of the cavernous body from erection to rest should be above 60%;
the norm of the resistance index should be more than 0.85; pulsation - 4.

Common pathologies

Most often, with the help of ultrasound, the following pathologies are diagnosed. Testicular torsion, which is related to injuries resulting from overexertion of the abdominal muscles. This pathology is accompanied by swelling, pain, often occurs in young boys.

Spermatocelle characterizes the enlargement of the testicles, which causes discomfort, pressure that increases during walking, any change in position. This condition can cause a cyst and lead to its rupture. Ultrasound of the vessels of the scrotum allows you to identify impaired blood flow, shows constricted vessels, injuries. This facilitates early initiation of therapy.

Ultrasound of the scrotum is a procedure for examining the scrotum using high-frequency ultrasound waves, which allow you to see its internal structure. This method refers to the primary diagnostic measure that helps to identify the presence of pathologies in men's health.There is no need to talk about the importance of early detection of diseases, since our health and life expectancy directly depend on this.

What are the indications for research

Ultrasound of the scrotum is prescribed in the following cases:

male infertility
an increase in the size of the epididymis and testis
erectile dysfunction (inability to achieve an erection)
pain in the scrotum and swelling
suspicion of inflammatory diseases of the testicles and scrotum (orchitis, epididymitis, epididymitis orchitis)
organ injury (hemorrhage, hematoma, tissue damage)
the appearance of tumor-like formations in the testicle and outside it
reduction of one or both testicles in size, which is accompanied by sagging of the scrotum on one or both sides, respectively
puberty ahead of time, or, conversely, the presence of signs of its slowdown
change in spermogram readings
swollen lymph nodes, which may indicate the presence of malignancy in the testicles
suspected varicose vein
surveillance of previously detected tumors, infections and leukemias
Cryptorchidism - an anomaly of the testicles, characterized by their absence (one or both at once) or a non-standard position in the inguinal region
endocrine diseases
suspected inguinal hernia with partial entry into the scrotum
monitoring the state of the body after the operations performed on it.

If it is necessary to assess the condition of the scrotum and the parameters of blood flow in it, an ultrasound of the vessels of the scrotum is performed. The procedure allows you to identify the true factors that caused many diseases (for example, varicocele).

It is also possible to accurately determine the presence of testicular torsion. With conventional ultrasound, this pathology is not accurately detected. Dopplerography of the scrotum is quite affordable and informative study.

Do I need to prepare for this procedure?

Special preparation for ultrasound of the scrotum is not required.. The only condition for performing this study is the hygienic treatment of the penis.

The sequence of the study

How is an ultrasound of the scrotum done?

the patient is placed on the couch, on the back or on the side
a special gel is applied to the scrotum area, which helps to establish safe contact between the patient's skin and the ultrasound machine
examination of the scrotum using an electromagnetic sensor.

What ultrasound parameters are normal?

In the absence of pathologies, the following criteria and characteristics of the examination should be present in the protocol of this study:

Testicles:

determined
size: for an adult male, it should be - 3-5 cm in length, 2-3 cm in width
contours: smooth, clear
the presence of additional formations: not found.

Appendages:

head size: no more than 10-15 mm
tail and body: not visible
echostructure: homogeneous, isoechoic
contours: clear, even
the presence of additional formations was not detected.

Free Liquid:

homogeneous
the amount is within the normal range (1-2 ml).

Scrotum:

wall thickness no more than 8 mm.

Deciphering the study in pathologies

The results of ultrasound of the scrotum in the presence of various diseases:

Epididymitis:

an increase in the size of the head of the appendage with a change in its structure
the tail and body of the appendage can be seen
the presence of fluid in the scrotum is possible (a similar pathology can be observed with: hydrocele, lymphocele, hematocele).

Adnexal abscess:

the presence of a volumetric formation with uneven contours and reduced echogenicity
foci of rarefaction with the same uneven edges are visible.

Closed injury:

uneven contours of the testicles and their irregular shape
heterogeneity of the echostructure
the presence of fluid at the site of injury.

Adnexal cyst:

the presence of a round, clear formation, inside which liquid is visible
a septum is visible in the cyst.

testicular tumor:

irregular shape
the presence of voluminous formations of increased or reduced echo density, both in the testicle itself and outside it
increased volume of fluid in the scrotum.

Infertility:

cysts of the epididymis and spermatic cord are found, squeezing the vas deferens.

Are there any risks from an ultrasound?

Ultrasonic waves, with which the procedure is carried out, are not radiation, therefore no harm from this study.

With urological problems, ultrasound of the scrotum is often prescribed. The scrotum is a musculoskeletal sac-like formation in men, which includes organs such as testicles, spermatic cords and appendages. The organs are located in such a way that they can only be examined with the help of an ultrasound examination.

The ultrasound examination procedure allows you to qualitatively and informatively perform diagnostics, assess the condition of the reproductive organs of a man.

Benefits of this procedure

With the help of ultrasound, the genitals of a man are scanned, the internal state is assessed. Ultrasound has its advantages:

absolutely safe method that does not irradiate the body. The result of the conduct is very informative and accurate;
using Doppler ultrasound, you can assess not only the state of the organs located in the scrotum, but also view the circulatory system;
contact method of examination, which does not cause discomfort or pain.

With all the many advantages, there are also some kind of disadvantages. Ultrasound is difficult to diagnose a malignant tumor. Even if the tumor has been established, there is no way to establish its nature - benign or malignant. Therefore, performing an ultrasound examination is the primary procedure for examining the genital organs. If necessary, the urologist may prescribe additional examinations, in addition to ultrasound.

Indications for carrying out

Usually, an ultrasound is prescribed by a urologist. Additionally, an ultrasound examination with Doppler can be performed to determine the state of the vessels of this organ. Indications for examination:

carried out to control the body after operations;
with a diagnosis of "male infertility";
the risk of a hernia moving to the inguinal region;
with an increase in the testicles and their appendages;
the presence of diseases of the endocrine system;
lack of erection;
if the patient does not have one or both testicles;
the appearance of pain in the scrotum and its swelling;
in the presence of tumors or chronic diseases;
suspicion of inflammatory processes;
suspicion of the appearance of varicose veins of the testicle or spermatic cord (varicocele);
after suffering an injury;
sometimes an examination is performed with an increase in lymph nodes;
if there are tumors on the scrotum;
a survey is carried out in adolescence to establish early or late puberty;
poor sperm counts.

Carrying out the procedure

Photograph of ultrasound of the scrotum - testicles

Before performing the examination procedure on the organs of the scrotum, special preparation is not needed.

The study is performed in a lying position. A conductive contact gel is applied to the desired area of study. It is desirable that the gel is not cold, otherwise the testicles may be drawn into the abdominal cavity from the cold, which will not allow the examination to be carried out as needed.

If pain occurs in the area of the scrotum upon contact with the sensors (in the case of tumors of unknown etiology), then local anesthesia is performed.

The condition and structure of one testicle is examined first, then the second.

When conducting ultrasound with Doppler, the venous plexuses and the condition of the vessels in the inguinal region are carefully checked.

The ultrasound procedure itself is performed within 15 minutes, in some cases, for example, with difficult visualization of organs, it can last up to half an hour.

Doppler ultrasound

This procedure is aimed at studying the vessels, veins, capillaries and blood flow, its direction in the inguinal region and its organs. With the help of Doppler, you can evaluate:

the level of enrichment of the scrotum with blood;
assessment of the rate of blood supply, the volume of supplied blood;
condition of vessels, their structure and walls.

Dopplerography of the vessels of the inguinal region does not require special training.

Doppler examination allows the doctor to identify the weakest places in the vascular bed in the groin and prescribe the appropriate treatment.

What diseases can be detected by ultrasound

During the ultrasound of the testicles, the doctor can make a preliminary diagnosis, which can later be confirmed after additional examinations and tests. During an ultrasound examination, the following pathologies can be preliminarily set:

Testicular cysts. They are single unilateral neoplasms of small size, usually found by a sonologist in the middle of the gonad. Testicular cysts are congenital and acquired (neoplasms of the epididymis), the latter often simulate hydrocele.
Congenital dropsy (hydrocele) of one or both testicles.
An ultrasound of the scrotum can reveal tumors.
If a child is examined, then an ultrasound scan can reveal a disease such as male hypogonadism (gonadal insufficiency), in fact, this is testicular failure, in which the production of sex hormones decreases.
Detection of calcifications. In ultrasound examination, calcifications are visualized as echopositive inclusions of high visibility.
In boys, such a temporary pathology as the failure of one testicle to descend into the scrotum can be detected. Surgical intervention in this case is not necessary until a certain age.
Infertility.
Testicular torsion, that is, compression of the spermatic cord. Occurs with injuries and physical exertion. In subacute torsion, a Doppler study is usually performed.
Inflammation of the epididymis (epididymitis). It causes acute pain and swelling of the scrotum in men of any age. Inflammation occurs when an infection from the prostate or bladder enters the epididymis. Doppler ultrasound is more informative than standard B-mode ultrasound. A diffuse or local increase in blood flow is found in the tissues of the epididymis and the testicle itself.
Tumor on testicles.
Abscess.
A retention cyst is a neoplasm on the spermatic cord, called a spermatocele. Diagnosis is performed to rule out malignancy.
Varicocele is a varicose vein of the eyelids of the spermatic cord. For diagnosis and surgical treatment, conventional ultrasound is used in combination with Doppler, as well as with a Valsalva test.
Various injuries.

Why are ultrasounds performed on children?

Image of the organs of the scrotum in men

Assign ultrasound of the scrotum to children to establish the full development of the genital organs. Such an examination should be carried out in order to study the functions of the reproductive system and determine the status of the hormones of the child. First of all, an event is carried out to identify pathologies at an early stage and eliminate this problem.

An ultrasound of the scrotum is prescribed for children if, during the examination, an increase in the testicles or a change in their shape in case of an injury to the inguinal region was found. If a child has precocious puberty, or vice versa, he lags behind in development, then an ultrasound of the scrotum is also shown to him. Children may have some deviations:

Cysts and tumors.
The occurrence of dropsy due to the inflammatory process.
Failure of one of the testicles to descend into the scrotum.
Poor blood supply to the vessels.

The child needs psychological preparation before the procedure. He should be told how the examination will be carried out, why it is done. When conducting an ultrasound scan for a child, it is advisable for parents to be nearby so that the baby does not experience discomfort. Preparation for the procedure is not needed, it is enough to take a diaper and napkins to wipe off the remains of the gel after the end of the ultrasound examination.

Interpretation of ultrasound indicators

If no pathologies were detected during an ultrasound of the testicles in men, then in the protocol you can read the following indicators that indicate the norm of the organs:

Testicles. Well viewed. The size of the testicles of an adult male is 2.5-6 cm long, 1.5-3 cm wide. The outlines should be even. Homogeneous echogenicity. No neoplasms.
Scrotum. The thickness of the walls of a healthy scrotum should be no more than 8 mm.
Appendages. Head parameters are approximately 10-15 mm. No neoplasms. The body and tail must not be visible. Homogeneous echogenic structure. The outlines are even, not bumpy.
free liquid. The amount of free liquid should not exceed 1-2 ml, and the liquid itself should be homogeneous, without impurities.

Deciphering ultrasound indicators in pathologies

In the presence of a disease, there may be such indicators:

Infertility. Cysts that compress the vas deferens can be found.
Epididymitis. Changing the structure of the head and its dimensions. The body and tail of the appendage can be visualized. The presence of fluid, which may indicate the presence of a lymphocele, hydrocele and other diseases.
Testicular tumor. Changes in the structure and shape of the testicle. The presence of formations that are located both outside the testicle and on it. The echogenic structure in such tumors is reduced. The presence of fluid.
The process of abscess on the appendage. The presence of a large neoplasm that has uneven contours and a reduced echogenic structure. Foci may appear.
Adnexal cyst. It looks like a round smooth formation with a liquid inside. A septum may be seen within the cyst.
The injury is closed. Change in the structure of the testicle and its uneven contours. The echostructure is heterogeneous. Collection of fluid in the area of injury.

Is there a risk with an ultrasound?

Ultrasound devices are based on the principle of ultrasonic waves, so this diagnostic does not have a negative impact on human health.

An ultrasound examination is a method for timely diagnosis and effective treatment. Therefore, if there are any problems with men's health, it is recommended to conduct an ultrasound scan.

At an early stage of development, the embryo has prototypes of male and female genital organs - mesonephric (Wolffian) and paramesonephric (Mullerian) channels, respectively. At the seventh week of pregnancy, the Y chromosome triggers the development of the testicles. The testicles produce testosterone, which promotes the development of the mesonephric ducts and inhibits the development of the paramesonephric ducts. From 18-20 weeks, you can determine the sex of the fetus on ultrasound.

The structure of the inguinal-scrotal region (according to Prives)

The testicles, testis (Greek - orchis, didymis), are a pair of oval-shaped bodies somewhat flattened from the sides, located in the scrotum. The length of the testicle is on average 4 cm, diameter 3 cm, weight from 15 to 25 g.

The spermatic cord, funiculus spermaticus, and the epididymis, epididymis, approach the posterior edge of the testicle; the latter is located along the posterior margin. Epididymis is a narrow long body, in which there is an upper, somewhat thickened part - the head of the appendage, caput epididymidis, and a lower, more pointed end, cauda epididymidis; the intermediate section makes up the body, corpus epididymidis. In the region of the body between the anterior concave surface of the epididymis and the testis, there is a pocket, sinus epididymidis, lined with a serous membrane and open to the lateral side.

At the upper end of the testicle is often a small process - appendix testis; on the cut, it consists of thin tubules; represents, apparently, a rudimentary process of the paramesonephric duct. Appendix epididymidis is found on the head of the appendage, usually sitting on a stalk (the remnant of the wolf body, mesonephros).

The testicle is surrounded by a dense fibrous membrane of a whitish color, tunica albuginea, lying directly on the parenchyma of the testicle. Along the posterior edge, the shell protrudes for a short distance into the glandular tissue of the testis in the form of an incomplete vertical septum or thickening, called the mediastinum testis; fibrous septa radiate from the mediastinum, which, with their outer ends, are attached to the inner surface of the tunica albuginea and, thus, divide the entire parenchyma into lobules. The number of lobules of the testicle reaches 250-300. The tops of the lobules face the mediastinum, and the bases face the tunica albuginea. The epididymis also has tunica albuginea, but thinner.

The testicular parenchyma consists of seminiferous tubules, in which two sections are distinguished - tubuli semeniferi contori and tubuli seminiferi recti. Each lobule has 2-3 tubules or more. Having a sinuous direction in the lobule itself, the seminiferous tubules, tubuli seminiferi contori, approaching the mediastenum, connect with each other and narrow directly at the mediastenum into short straight tubes - tubuli seminiferi recti. Direct tubules open into a network of passages - rete testis, located in the thickness of the mediastinum. From the network of the testis, 12-15 efferent tubules open - ductuli efferentes testis, which go to the head of the epididymis. Upon exiting the testis, the efferent tubules become tortuous and form a series of conical lobules of the appendage, lobulus s. coni epididymidis. The ductuli efferentes open into a single canal of the appendage, the ductis epididymidis, which, forming numerous bends, continues into the ductis deferens. Being straightened, the appendage canal reaches 3-4 m in length. Ductuli efferentes, lobuli epididydimidis and the initial section of the canal of the epididymis together form the head of the epididymis. On the epididymis there are side ducts, ductuli aberrantes. Just above the head of the appendage, anterior to the spermatic cord, there is a small body, paradidymis, which represents a rudimentary remnant of the primary kidney.

The site of secretion of the male seed, sperma, is only tubuli seminiferi contori. Tubuli recti and testicular tubules already belong to the excretory tract.

The testicles, located in the scrotum, are, as it were, suspended in it with the help of the spermatic cords. The composition of the spermatic cord, funiculus spermaticus, includes ductus deferens, aa. et vv. testiculares et deferentiales, lymphatic vessels and nerves. At the deep ring of the inguinal canal, the components of the spermatic cord diverge, so that the spermatic cord as a whole extends only from the posterior edge of the testicle to the deep ring of the inguinal canal. The spermatic cord is formed only after the descent of the testicle into the scrotum from the abdominal cavity, where it initially develops.

In lower mammals, the testicle is located in the abdominal cavity. In more highly organized, for example, in rodents, it temporarily comes out during the mating period of animals. These animals have a highly developed muscle that lifts the testicle, m. cremaster, which is reduced in higher mammals and humans, since in them the testis completely exits the abdominal cavity into the scrotum. As a reflection of this process in a person, descent of the testicle is observed in ontogenesis.

In the embryo, the testicles are located on the posterior abdominal wall at the level of the upper two lumbar vertebrae. From the lower end of the testicle, a cord stretches down, the conductor of the testicle, gubernaculum testis, consisting of smooth muscle fibers and fibrous tissue and heading with its lower end to the inguinal region, being laid in the fold of the peritoneum. In parallel with the growth of the embryo, the testis gradually occupies a lower and lower level. On the 3rd month it lies in the iliac fossa, on the 7th month it is located near the deep ring of the inguinal canal.

Even much earlier than the exit of the testicle from the abdominal cavity, the peritoneum gives rise to a blind process, processus vaginalis peritonei, which goes through the anterior abdominal wall to the scrotum, receiving membranes from all layers of the abdominal wall in its path. Following the path of the processus vaginalis, the testicle descends into the scrotum, for the most part, even before the birth of the child, occupying its final position in it. Due to the overgrowth of the upper portion of the vaginal process, the previously existing connection between the peritoneum and the serous membrane of the testicle is interrupted. If the vaginal process is not overgrown, an open canal remains through which congenital hernias can exit.

Together with the release of the testicle from the abdominal cavity, the gubernaculum testis undergoes atrophy. Some authors believe that the shortening of the conductor during its atrophy partially contributes to the process of testicular descent. If this process is disturbed, the testicle either remains in the abdominal cavity or stops in the inguinal canal, as is observed in animals. Such an abnormal position of the testicle is a developmental anomaly - and cryptorchidism.

The testicle, which has taken its position, is located together with the lower part of the spermatic cord in the scrotum, scrotum. The scrotal suture, raphe scroti, runs along the midline of the scrotum, starting on the lower surface of the penis and extending to the anus. The rest of the scrotum is covered with a more or less significant number of wrinkles.

The shells of the testicle and spermatic cord, counting from the outside, are as follows: skin, tunica dartos, fascia spermatica externa, fascia cremasterica, m. cremasterica, fascia spermatica interna, tunica vaginalis testis. Such a large number of testicular membranes corresponds to certain layers of the anterior abdominal wall. It seems that the testicle, when it was displaced from the abdominal cavity, dragged along the peritoneum and fascia of the abdominal muscles and was enveloped in them.

The skin of the scrotum is thinner and darker than other parts of the body. It is supplied with numerous large sebaceous glands, the secret of which has a special characteristic odor.
Tunica dartos, the fleshy shell, is located just under the skin. It is a continuation of the subcutaneous connective tissue from the groin and perineum, but is devoid of fat. It contains a significant amount of smooth muscle fibers. Tunica dartos forms one separate sac for each testis, connected to each other along the midline, so that a septum, septum scroti, is obtained, attached along the raphe line.
Fascia spermatica externa is a continuation of the superficial fascia of the abdomen.
Fascia cremasterica is a continuation of the fascia intercruralis, extending from the edges of the superficial inguinal ring; she covers m. cremaster, which is why it is called f. cremasterica.
M. cremaster consists of bundles of striated fibers that are a continuation of m. transverse abdominalis. When reducing m. cremaster the testicle is pulled up.
Fascia spermatica interna - internal seminal fascia, located immediately under m. cremaster. it is a continuation of the fascia transverzalis, it covers all the components of the spermatic cord and, in the area of the testicle, is adjacent to the outer surface of its serous cover.
Tunica vaginalis testis, the vaginal membrane of the testicle, occurs due to the processus vaginalis of the peritoneum and forms a closed serous sac, consisting of two plates: laminaparietalis, parietal plate, and lamina visceralis, visceral plate. The visceral plate is closely fused with the albuginea of the testicle and also passes to the epididymis. Between the lateral surface of the testicle and the middle part of the epididymis (body), the visceral plate enters the slit space between them, forming a pocket called sinus epididymidis. Along the posterior edge of the testicle, at the place where the vessels exit, the visceral plate passes into the parietal plate. Between the parietal and visceral plates facing each other there is a slit-like space - cavum vaginale, in which, in pathological cases, a large amount of serous fluid can accumulate and give dropsy of the testicle.

At what age is it necessary to do an ultrasound of the scrotum

Scheduled ultrasound examination is carried out at the age of:

6-12 months- By the age of 1 year, the processes of obliteration of the vaginal process of the peritoneum and testicular migration should be completed. A study at this age is carried out in order to identify hidden anomalies.
5-9 years old- From 5 to 9 years, the size of the testicles increases. Small testicles may be a sign of hypogonadism or functional developmental delay. An ultrasound sign of the constitutional form of hypogonadism is an increase in testicular volume by more than 2% and a sharp increase in intraorganic blood flow after injections of choriotropic hormone.
10-14 years old- From 10 to 14 years, a lumen appears in the convoluted seminiferous tubules containing mature spermatogenic cells. The mass of the testicle doubles. The intensity of regional blood circulation increases proportionally, which is a provocative moment for the occurrence of varicocele. Latent forms of the disease can be detected on ultrasound using dynamic tests (for more details, see).

scrotum ultrasound

The echostructure of the contents of the scrotum is best seen when scanning with a high-frequency probe 7.5-15 MHz. A low-frequency probe of 3.5-5 MHz can be useful for scanning the edematous scrotum and the main vessels of the testis. An ultrasound of the scrotum is performed with the patient in the supine position, a towel between the thighs serves as a support for the scrotum, the penis is pressed against the stomach.

testicle on ultrasound is an oval formation with smooth contours and a homogeneous fine-grained structure. Since there is a liquid component in the lumen of the seminiferous tubules, they have reduced echogenicity, and the stroma and vessels are brighter areas. The number of echogenic structures increases with age and is especially large in the pubertal period due to the activation of the processes of vascularization of the testicular tissue.

A photo. Cross section of the testicles: The mediastinum of the testis is located eccentrically on the transverse section (red arrows). The scrotum is divided into two compartments by a fibrous septum. The skin and fleshy membrane are hyper- and hypoechoic linear structures. The vaginal membrane forms a closed serous cavity with a small amount of fluid - a thin anechoic zone between hyperechoic linear structures. Cross section of both testicles is useful for comparative analysis of echostructure and blood flow.

A photo. Longitudinal section of the testis: In the longitudinal section, the mediastinum of the testis is a hyperechoic line in the center (arrows). The inner leaf of the vaginal membrane is tightly attached to the tunicae albugineae (arrows) and covers the appendage throughout.

To determine the size of the testicle during longitudinal scanning, the length and thickness are measured. In transverse scanning, the width and thickness are measured. The thickness on the transverse and longitudinal sections have approximately the same value.

The volume of the testicle is calculated by the formula: length (cm) x width (cm) x thickness (cm) x 0.523.

A photo. A - length (1), width (2) and thickness (3). B - width (1), length (2) and thickness (3).

See normal testicle sizes in adults and children of all ages.

Epididymis on ultrasound

At an early age, the epididymis on ultrasound in echogenicity does not differ from the echogenicity of the testicles, which is due to the morphological immaturity of both organs. Their structure is dominated by echo-negative shades. A deep sinus with liquid content between the body of the epididymis and the upper pole of the testicle may not be expressed. The testicle and its appendage can be taken as a single formation and cause errors in measurement.

The period of intensive development of the reproductive system begins at the age of 10-14 years. By this time, mature germ cells and seminal fluid appear in the lumen of the vas deferens, which make up the appendage. Formed appendage on ultrasound: homogeneous heterogeneous formation of a semi-oval form of medium echogenicity with clear contours. The appendage is covered with a protein membrane, the head is located in the serous cavity, which acquires the meaning of an "acoustic window". The tail and a significant part of the body are outside this cavity, and therefore are not detected by ultrasound methods.

A photo. The head of the epididymis (blue arrow) is a triangular formation, iso- or slightly hyperechoic in relation to the testicle, at the upper pole of the testicle. The tubules become more organized towards the caudal region, so the body (red arrows) and tail (yellow arrow) are often hypoechoic.

In the first years of postnatal development of the child, the size of the epididymis approaches the size of the testicle. Up to 7 years, it practically does not change, at 7-11 years it doubles. In the pubertal period, the size of the appendage increases several times, reaching 10-15 mm in width and 6-8 mm in thickness. See normal sizes of the epididymis in adults and children of different ages.

Hydatids of the testicle and epididymis, which belong to normal anatomical formations, can be seen with a hydrocele (see for more details. These are formations with a diameter of 2-3 mm, of medium echogenicity, attached to the testicle or epididymis.

Inguinal canal on ultrasound

The inguinal canal is studied in B-mode for cryptorchidism and to detect abnormalities of the vaginal process of the peritoneum.

Against the background of fatty tissue, the anterior wall of the inguinal canal, formed by the aponeurosis of the external oblique muscle of the abdomen, stands out in a separate bright structure and emphasizes the anterior contour of the spermatic cord. The transverse fascia, which makes up the posterior wall, is associated with the peritoneum, highlighting the opposite contour of the funiculus. The inguinal canal is easier to visualize in men, as the heterogeneous tubular structures of the spermatic cord are clearly visible surrounded by hyperechoic fat.

When searching inner ring of the inguinal canal the reference point is the inferior epigastric artery, which is accompanied by a vein near the medial edge of the peritoneal funnel of the vaginal process. The transducer is placed transversely just below the navel and lowered along the inferior epigastric artery until a convex hyperechoic linear structure appears behind the rectus abdominis muscle - this is the upper part of the inguinal canal.

A photo. A - Inferior epigastric arteries and veins (asterisks) depart from the external iliac arteries just above the inguinal ligament (IL), pass behind the inguinal canal (IC) and medially to the edge of the deep inguinal ring (D) enter the posterior sections of the rectus abdominis muscle (R). B - With CDI, the epigastric artery and veins (arrow) are clearly visible on the transverse section of the rectus abdominis muscle on the right just below the navel.

A photo. A, B - When the epigastric vessels leave the rectus abdominis muscle and go posterolaterally to the external iliac vessels, an arcuate hyperechoic linear structure (triangles) appears behind the rectus abdominis muscle - this is the upper part of the inguinal canal. On ultrasound, the deep ring of the inguinal canal in men (A) is seen better than in women (B). C - On the side of the lower epigastric vessels, when scanning parallel to the inguinal ligament, a hypoechoic ventral funnel of the vaginal process (arrows) is visible - this is the inner ring of the inguinal canal.

Outer ring of the inguinal canal are recognized by a change in the direction of the acoustic structures of the Thomson and superficial fascia, which in this place move to the spermatic cord. This transition is clearly visible when scanning the cord at the root of the scrotum.

The length of the inguinal canal in children of the first year of life varies between 0.5-2.5 cm. With age, it lengthens and becomes narrower.

spermatic cord on ultrasound

The spermatic cord is the structures that pass through the inguinal rings as the testicles descend into the scrotum. The spermatic cord includes the remnants of the vaginal membrane, the vas deferens, the lymphatic vessels, the testicular artery, the cremasteric artery and the vas deferens artery, and the veins. The veins form a network of anastomoses - the pampiniform (pampiniform) plexus, which runs along the posterior surface of the testicles and along a significant length of the vas deferens. At the level of the deep inguinal ring, they are converted into the testicular vein.

On ultrasound of the spermatic cord It is represented by linear structures that correspond to the arterial and venous vessels passing here. The vas deferens is not detected echographically.

A photo. Transverse scan of the inguinal region just below the inguinal ligament. Inward from the common femoral artery (A) and vein (V), the vas deferens and vessels of the spermatic cord in the inguinal canal are visible - these are anechoic oval-shaped structures (arrows). For comparison, a similar scan of the contralateral side (A and B, C and D) is performed. On image C, the structures of the spermatic cord are not determined. If it is not possible to find a testicle in the inguinal canal, then the testicles are searched in the abdominal cavity along the iliac vessels up to the aortic bifurcation and in the pelvis. If necessary, use a lower frequency sensor.

Intraorganic arteries and veins of the testicles are well defined in CDI, especially in the ED mode. The color cartogram is characterized by a uniform distribution of blood flows in the parenchyma. The superficial network of vessels localized in the inner layer of the albuginea (tunica vasculosa) stands out more clearly. In children, the intensity of blood circulation increases in proportion to age. In adolescents of prepubertal and pubertal age, quantitative and qualitative analysis of blood flow becomes possible.

Intratesticular arteries have low peripheral resistance. Similarly, the blood flow in the main trunk of the testicular artery can be characterized, which is best detected in the interval between the head of the epididymis and the upper pole of the testis. The blood flow in the arteries of the spermatic cord may have a main altered type of Doppler spectrum, so the interlobular arteries are more sensitive to various influences.

An important area of ultrasound is the initial section of the spermatic cord from the place of its formation to the level of the superficial inguinal ring. Here, the veins of the pampiniform plexus are especially well visualized, the diameter of which normally varies from 0.5 to 3 mm. The composition of the pampiniform plexus includes from 10 to 45 vessels, complexly and repeatedly anastomosing with each other. In the B-mode, the vascular geometry of the venous plexus is specified, the presence or absence of varicose veins is ascertained.

With the help of the color flow chart, the state of the valve apparatus in the venous system is determined by stress tests. When the position of the patient's body changes from horizontal to vertical, the direction of blood flow in the color cartogram normally remains in the correct direction, anterograde. On a deep breath with a held breath with functioning valves, the veins become empty. On exhalation, the natural direction of blood flow resumes and increases in intensity. With coughing movements, the blood flow becomes intermittent, but anterograde. The diameter of the veins with tension of the muscles of the anterior abdominal wall should not increase by more than 1 mm. A negative result of functional stress tests indicates valvular venous insufficiency (for more details, see).

Vascular examinations of the inguinal canal are performed mainly to identify the inguinal canal. The testicular artery, cremasteric artery, and vas deferens artery have approximately similar Doppler characteristics and are difficult to verify.

Pay attention to the RI of the interlobular testicular arteries. Normal RI is 0.6-0.7. With arteriovenous shunting and collateral circulation, RI decreases. When the RI is below 0.4, the sperm is of poor quality.

Picture. On ultrasound, a normal testicle. The spectrum of interlobular arteries has a smooth rise, a rounded systolic peak, a gentle descent, and a pronounced end-diastolic component.

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Topic: ultrasound examination of organs and tissues (instructions for use).

Features of the ultrasound of the scrotum

For ultrasound examination of the scrotum, linear transducers of 5-12 MHz are used.

With ultrasound of the scrotum, a longitudinal image of the testicle and its poles, head of the epididymis, body and tail is obtained, and then a transverse image to assess the echostructure, contours, sizes, and the presence of formations. The symmetry of the findings is compared with the contralateral testis and epididymis. The examination is supplemented with an assessment of vascularization and hemodynamics in the modes of ultrasonic angiography (color Doppler mapping and color Doppler energy mapping). To exclude varicocele, a stress test (Valsalva test) is performed.

Protocol for ultrasound examination of the scrotum

Here is a unified protocol for ultrasound of the scrotum, which indicates the minimum necessary diagnostic actions during the study. In addition, each specific institution can use additional ultrasonic characteristics and criteria.

ULTRASONIC EXAMINATION OF THE SCROMONAL ORGANS (protocol)

Name _________ Age ___

Date of examination _________

Testicles: right | left dimensions ___mm | ___mm

volume ___ cm3 | ___ cm3

Features of echostructure ___ | ___ Vascularization ___ | ___ Contours ___ | ___

Capsule ___ | ___

Stress test: ______

Conclusion __________________ Doctor _________

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Ultrasound of the scrotum (lecture at the Diagnostic) - Diagnostic

The structure of the inguinal-scrotal region (according to Prives)

At the upper end of the testicle there is often a small process - appendix testis; on the cut, it consists of thin tubules; represents, apparently, a rudimentary process of the paramesonephric duct. Appendix epididymidis is found on the head of the appendage, usually sitting on a stalk (the remnant of the wolf body, mesonephros).

The parenchyma of the testis consists of seminiferous tubules, in which two sections are distinguished - tubuli semeniferi contori and tubuli seminiferi recti. Each lobule has 2-3 tubules or more. Having a sinuous direction in the lobule itself, the seminiferous tubules, tubuli seminiferi contori, approaching the mediastenum, connect with each other and narrow directly at the mediastenum into short straight tubes - tubuli seminiferi recti. Direct tubules open into a network of passages - rete testis, located in the thickness of the mediastinum. From the network of the testis, 12-15 efferent tubules open - ductuli efferentes testis, which go to the head of the epididymis. Upon exiting the testis, the efferent tubules become tortuous and form a series of conical lobules of the appendage, lobulus s. coni epididymidis. The ductuli efferentes open into a single canal of the appendage, the ductis epididymidis, which, forming numerous bends, continues into the ductis deferens. Being straightened, the appendage canal reaches 3-4 m in length. Ductuli efferentes, lobuli epididydimidis and the initial section of the canal of the epididymis together form the head of the epididymis. On the epididymis there are side ducts, ductuli aberrantes. Just above the head of the appendage, anterior to the spermatic cord, there is a small body, paradidymis, which represents a rudimentary remnant of the primary kidney.

The site of secretion of the male seed, sperma, is only tubuli seminiferi contori. Tubuli recti and testicular tubules already belong to the excretory tract.

The skin of the scrotum is thinner and darker than other parts of the body. It is supplied with numerous large sebaceous glands, the secret of which has a special characteristic odor.
Tunica dartos, the fleshy shell, is located just under the skin. It is a continuation of the subcutaneous connective tissue from the groin and perineum, but is devoid of fat. It contains a significant amount of smooth muscle fibers. Tunica dartos forms one separate sac for each testis, connected to each other along the midline, so that a septum, septum scroti, is obtained, attached along the raphe line.
Fascia spermatica externa is a continuation of the superficial fascia of the abdomen.
Fascia cremasterica is a continuation of the fascia intercruralis, extending from the edges of the superficial inguinal ring; she covers m. cremaster, which is why it is called f. cremasterica.
M. cremaster consists of bundles of striated fibers that are a continuation of m. transverse abdominalis. When reducing m. cremaster the testicle is pulled up.
Fascia spermatica interna - internal seminal fascia, located immediately under m. cremaster. it is a continuation of the fascia transverzalis, it covers all the components of the spermatic cord and, in the area of the testicle, is adjacent to the outer surface of its serous cover.
Tunica vaginalis testis, the vaginal membrane of the testicle, occurs due to the processus vaginalis of the peritoneum and forms a closed serous sac, consisting of two plates: laminaparietalis, parietal plate, and lamina visceralis, visceral plate. The visceral plate is closely fused with the albuginea of the testicle and also passes to the epididymis. Between the lateral surface of the testicle and the middle part of the epididymis (body), the visceral plate enters the slit space between them, forming a pocket called sinus epididymidis. Along the posterior edge of the testicle, at the place where the vessels exit, the visceral plate passes into the parietal plate. Between the parietal and visceral plates facing each other there is a slit-like space - cavum vaginale, in which, in pathological cases, a large amount of serous fluid can accumulate and give dropsy of the testicle.

At what age is it necessary to do an ultrasound of the scrotum

Scheduled ultrasound examination is carried out at the age of:

6-12 months - By the age of 1 year, the processes of obliteration of the vaginal process of the peritoneum and testicular migration should be completed. A study at this age is carried out in order to identify hidden anomalies.
5-9 years - From 5 to 9 years, the size of the testicles increases. Small testicles may be a sign of hypogonadism or functional developmental delay. An ultrasound sign of the constitutional form of hypogonadism is an increase in testicular volume by more than 2% and a sharp increase in intraorganic blood flow after injections of choriotropic hormone.
10-14 years - From 10 to 14 years, a lumen appears in the convoluted seminiferous tubules containing mature spermatogenic cells. The mass of the testicle doubles. The intensity of regional blood circulation increases proportionally, which is a provocative moment for the occurrence of varicocele. Hidden forms of the disease can be detected on ultrasound using dynamic tests (for more details, see here).

scrotum ultrasound

The testicle on ultrasound is an oval formation with smooth contours and a homogeneous fine-grained structure. Since there is a liquid component in the lumen of the seminiferous tubules, they have reduced echogenicity, and the stroma and vessels are brighter areas. The number of echogenic structures increases with age and is especially large in the pubertal period due to the activation of the processes of vascularization of the testicular tissue.

The volume of the testicle is calculated by the formula: length (cm) x width (cm) x thickness (cm) x 0.523.

See normal testicle sizes in adults and children of all ages here.

Epididymis on ultrasound

At an early age, the epididymis on ultrasound does not differ in echogenicity from the echogenicity of the testicles, which is due to the morphological immaturity of both organs. Their structure is dominated by echo-negative shades. A deep sinus with liquid content between the body of the epididymis and the upper pole of the testicle may not be expressed. The testicle and its appendage can be taken as a single formation and cause errors in measurement.

The period of intensive development of the reproductive system begins at the age of 10-14 years. By this time, mature germ cells and seminal fluid appear in the lumen of the vas deferens, which make up the appendage. Formed appendage on ultrasound: a homogeneous heterogeneous formation of a semi-oval shape of medium echogenicity with clear contours. The appendage is covered with a protein membrane, the head is located in the serous cavity, which acquires the meaning of an "acoustic window". The tail and a significant part of the body are outside this cavity, and therefore are not detected by ultrasound methods.

In the first years of postnatal development of the child, the size of the epididymis approaches the size of the testicle. Up to 7 years, it practically does not change, at 7-11 years it doubles. In the pubertal period, the size of the appendage increases several times, reaching 10-15 mm in width and 6-8 mm in thickness. Normal sizes of the epididymis in adults and children of different ages, see here.

Hydatids of the testicle and epididymis, which are normal anatomical structures, can be seen with a hydrocele (see more here). These are formations with a diameter of 2-3 mm, of medium echogenicity, attached to the testicle or epididymis.

Inguinal canal on ultrasound

The inguinal canal is studied in B-mode for cryptorchidism and to detect abnormalities of the vaginal process of the peritoneum.

When searching for the inner ring of the inguinal canal, the inferior epigastric artery, which is accompanied by a vein near the medial edge of the peritoneal funnel of the vaginal process, serves as a reference point. The transducer is placed transversely just below the navel and lowered along the inferior epigastric artery until a convex hyperechoic linear structure appears behind the rectus abdominis muscle - this is the upper part of the inguinal canal.

The outer ring of the inguinal canal is recognized by a change in the direction of the acoustic structures of the Thomson and superficial fascia, which in this place move to the spermatic cord. This transition is clearly visible when scanning the cord at the root of the scrotum.

The length of the inguinal canal in children of the first year of life varies between 0.5-2.5 cm. With age, it lengthens and becomes narrower.

spermatic cord on ultrasound

On ultrasound, the spermatic cord is represented by linear structures that correspond to the arterial and venous vessels passing here. The vas deferens is not detected echographically.

testicular doppler

With the help of the color flow chart, the state of the valve apparatus in the venous system is determined by stress tests. When the position of the patient's body changes from horizontal to vertical, the direction of blood flow in the color cartogram normally remains in the correct direction, anterograde. On a deep breath with a held breath with functioning valves, the veins become empty. On exhalation, the natural direction of blood flow resumes and increases in intensity. With coughing movements, the blood flow becomes intermittent, but anterograde. The diameter of the veins with tension of the muscles of the anterior abdominal wall should not increase by more than 1 mm. A negative result of functional exercise tests indicates valvular venous insufficiency (for more details, see here).

Picture. On ultrasound, a normal testicle. The spectrum of interlobular arteries has a smooth rise, a rounded systolic peak, a gentle descent, and a pronounced end-diastolic component.

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Ultrasound of the organs and vessels of the scrotum: norms, decoding, how a Doppler study is done

With urological problems, ultrasound of the scrotum is often prescribed. The scrotum is a musculoskeletal sac-like formation in men, which includes organs such as testicles, spermatic cords and appendages. The organs are located in such a way that they can only be examined with the help of an ultrasound examination.

The ultrasound examination procedure allows you to qualitatively and informatively perform diagnostics, assess the condition of the reproductive organs of a man.

Benefits of this procedure

With the help of ultrasound, the genitals of a man are scanned, the internal state is assessed. Ultrasound has its advantages:

absolutely safe method that does not irradiate the body. The result of the conduct is very informative and accurate;
using Doppler ultrasound, you can assess not only the state of the organs located in the scrotum, but also view the circulatory system;
contact method of examination, which does not cause discomfort or pain.

Indications for carrying out

carried out to control the body after operations;
with a diagnosis of "male infertility";
the risk of a hernia moving to the inguinal region;
with an increase in the testicles and their appendages;
the presence of diseases of the endocrine system;
lack of erection;
if the patient does not have one or both testicles;
the appearance of pain in the scrotum and its swelling;
in the presence of tumors or chronic diseases;
suspicion of inflammatory processes;
suspicion of the appearance of varicose veins of the testicle or spermatic cord (varicocele);
after suffering an injury;
sometimes an examination is performed with an increase in lymph nodes;
if there are tumors on the scrotum;
a survey is carried out in adolescence to establish early or late puberty;
poor sperm counts.

Carrying out the procedure

Photograph of ultrasound of the scrotum - testicles

Before performing the examination procedure on the organs of the scrotum, special preparation is not needed.

If pain occurs in the area of the scrotum upon contact with the sensors (in the case of tumors of unknown etiology), then local anesthesia is performed.

The condition and structure of one testicle is examined first, then the second.

When conducting ultrasound with Doppler, the venous plexuses and the condition of the vessels in the inguinal region are carefully checked.

The ultrasound procedure itself is performed within 15 minutes, in some cases, for example, with difficult visualization of organs, it can last up to half an hour.

Doppler ultrasound

This procedure is aimed at studying the vessels, veins, capillaries and blood flow, its direction in the inguinal region and its organs. With the help of Doppler, you can evaluate:

the level of enrichment of the scrotum with blood;
assessment of the rate of blood supply, the volume of supplied blood;
condition of vessels, their structure and walls.

Dopplerography of the vessels of the inguinal region does not require special training.

Doppler examination allows the doctor to identify the weakest places in the vascular bed in the groin and prescribe the appropriate treatment.

What diseases can be detected by ultrasound

Testicular cysts. They are single unilateral neoplasms of small size, usually found by a sonologist in the middle of the gonad. Testicular cysts are congenital and acquired (neoplasms of the epididymis), the latter often simulate hydrocele.
Congenital dropsy (hydrocele) of one or both testicles.
An ultrasound of the scrotum can reveal tumors.
If a child is examined, then an ultrasound scan can reveal a disease such as male hypogonadism (gonadal insufficiency), in fact, this is testicular failure, in which the production of sex hormones decreases.
Detection of calcifications. In ultrasound examination, calcifications are visualized as echopositive inclusions of high visibility.
In boys, such a temporary pathology as the failure of one testicle to descend into the scrotum can be detected. Surgical intervention in this case is not necessary until a certain age.
Infertility.
Testicular torsion, that is, compression of the spermatic cord. Occurs with injuries and physical exertion. In subacute torsion, a Doppler study is usually performed.
Inflammation of the epididymis (epididymitis). It causes acute pain and swelling of the scrotum in men of any age. Inflammation occurs when an infection from the prostate or bladder enters the epididymis. Doppler ultrasound is more informative than standard B-mode ultrasound. A diffuse or local increase in blood flow is found in the tissues of the epididymis and the testicle itself.
Tumor on testicles.
Abscess.
A retention cyst is a neoplasm on the spermatic cord, called a spermatocele. Diagnosis is performed to rule out malignancy.
Varicocele is a varicose vein of the eyelids of the spermatic cord. For diagnosis and surgical treatment, conventional ultrasound is used in combination with Doppler, as well as with a Valsalva test.
Various injuries.

Why are ultrasounds performed on children?

Image of the organs of the scrotum in men

Cysts and tumors.
The occurrence of dropsy due to the inflammatory process.
Failure of one of the testicles to descend into the scrotum.
Poor blood supply to the vessels.

Interpretation of ultrasound indicators

If no pathologies were detected during an ultrasound of the testicles in men, then in the protocol you can read the following indicators that indicate the norm of the organs:

Testicles. Well viewed. The size of the testicles of an adult male is 2.5-6 cm long, 1.5-3 cm wide. The outlines should be even. Homogeneous echogenicity. No neoplasms.
Scrotum. The thickness of the walls of a healthy scrotum should be no more than 8 mm.
Appendages. Head parameters are approximately 10-15 mm. No neoplasms. The body and tail must not be visible. Homogeneous echogenic structure. The outlines are even, not bumpy.
free liquid. The amount of free liquid should not exceed 1-2 ml, and the liquid itself should be homogeneous, without impurities.

Deciphering ultrasound indicators in pathologies

In the presence of a disease, there may be such indicators:

Infertility. Cysts that compress the vas deferens can be found.
Epididymitis. Changing the structure of the head and its dimensions. The body and tail of the appendage can be visualized. The presence of fluid, which may indicate the presence of a lymphocele, hydrocele and other diseases.
Testicular tumor. Changes in the structure and shape of the testicle. The presence of formations that are located both outside the testicle and on it. The echogenic structure in such tumors is reduced. The presence of fluid.
The process of abscess on the appendage. The presence of a large neoplasm that has uneven contours and a reduced echogenic structure. Foci may appear.
Adnexal cyst. It looks like a round smooth formation with a liquid inside. A septum may be seen within the cyst.
The injury is closed. Change in the structure of the testicle and its uneven contours. The echostructure is heterogeneous. Collection of fluid in the area of injury.

Is there a risk with an ultrasound?

Ultrasound devices are based on the principle of ultrasonic waves, so this diagnostic does not have a negative impact on human health.

An ultrasound examination is a method for timely diagnosis and effective treatment. Therefore, if there are any problems with men's health, it is recommended to conduct an ultrasound scan.