Standard and Additional Imaging for Testes/Scrotum

Standard Imaging Protocol Right and Left Testes Transverse Images Epididymal head Superior testis Mid with trans measurement Mid with colour to document blow flow Inferior testes Epididymal tail Longitudinal Images Lateral testis Mid Mid with longitudinal and AP measurement Medial Superior Aspect Inferior Aspect Right and Left Epididymis Longitudinal Images with measurement of the thickness of epididymis Head Body Tail Comparison Transverse images demonstrating both testes to allow for comparison of echotexture

Standard Imaging of the Normal Testes Images 1-6 Transverse Images of the Testes

Standard Imaging of the Normal Testes Images 7-12 Longitudinal Images of the Testes

Standard Imaging of the Normal Testes Images 13-18 Epididymis

Image 13-14: B-mode and Colour Doppler Image of Epididymis Head

Image 15-16: B-mode and Colour Doppler Image of Epididymis Body

Image 17-18: B-mode and Colour Doppler Image of Epididymis Tail

Standard Imaging of the Normal Testes Images 19 - 20 Comparison Images

Image 19-20: B-mode and Colour Doppler Image of both testes Image 19-20: B-mode and Colour Doppler Image of both testes comparing echotexture and blood flow

Altering of Normal Protocol for Pathology The following is an adaptation of the standard imaging protocol. The patient was a 24 y/o male with a previous history of right orchidectomy and epididectomy as a result of childhood cryptorchidism and subsequent orchidopexy. The patient presented with a recurrence of left hydrocoele following surgical drainage four months prior to examination.

Adapted Image Protocol for Patient Particulars Left Testes Transverse Images Epididymal head Superior testis Mid with trans measurement Mid with colour to document blow flow Inferior testes Epididymal tail Longitudinal Images Lateral testis Mid Mid with longitudinal and AP measurement Medial Superior Aspect Inferior Aspect Left Epididymis Longitudinal Images with measurement of the thickness of epididymis Head Body Tail

Additional Imaging Images of relevant pathology including measurements Upper and lower segments of the apparent hydrocoele Colour Doppler imaging to assess if any pathological increase in vascularity is present Image demonstrating communication between superior and inferior segments of the hydrocoele

Pathology Identified in this Study A singular testes is noted. This is labelled as the left testes according to the patient and previous imaging. The remaining testicle is enlarged representing compensatory hypertrophy. There is a hydrocele present. Though several pockets of fluid are seen they appear to be communicating. Normal vascularity is present within the testes. No other mass or abnormality is present. There is no varicocele.

Patient Follow Up This patient returned to the department the following week for drainage of the hydrocele and for injection of a sclerosing agent.