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Metachronous bilateral segmental testicular infarction: multi-parametric ultrasound imaging with grey-scale ultrasound, Doppler ultrasound, contrast-enhanced ultrasound (CEUS) and real-time tissue elastography (RTE)

Journal of Ultrasound volume 17, pages 233–238 (2014)Cite this article

Abstract

Segmental testicular infarction is a rare cause of acute scrotal pain. The appearances on grey-scale sonography are often indistinguishable from that of a testicular tumour, resulting in unnecessary orchiectomy. We report a case of acute bilateral testicular infarction, of unknown etiology, which was conservatively managed to resolution following a confident diagnosis achieved with the aid of contrast-enhanced ultrasound (CEUS) and real-time tissue elastography (RTE) along with conventional grey-scale and Doppler sonography. The evolving appearances on each of the sonographic modalities are described. We discuss the importance of complementing conventional sonography with CEUS and RTE in order to make a confident diagnosis and avoid unnecessary surgical intervention.

Riassunto

L’infarto testicolare segmentale è una causa rara di dolore scrotale acuto. L’aspetto ecografico, in scala di grigi, è spesso indistinguibile da quello di un tumore testicolare, con conseguenti orchiectomie inutili. Riportiamo un caso di infarto testicolare acuto bilaterale, ad eziologia sconosciuta, gestito in maniera conservativa fino a risoluzione, dopo una diagnosi realizzata con l’ausilio di ecografia con messo di contrasto (CEUS) e elastosonografia tessutale in tempo reale (RTE), ecografia convenzionale in scala di grigi e Doppler. Sono descritti gli aspetti, in ciascuna delle modalità ecografiche, dell’evoluzione delle lesioni. Discutiamo l’importanza della complementarietà dell’ecografia convenzionale con CEUS e RTE per effettuare una diagnosi di certezza ed evitare un inutile intervento chirurgico.

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Conflict of interest

Ketul V. Patel, Dean Y. Huang, Paul S. Sidhu declare no conflict of interest with this case study. The patient gave informed consent to report the case.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2,000 (5). All patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.

Human and animal studies

The study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

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Affiliations

  1. Department of Radiology, King’s College Hospital, King’s College London, Denmark Hill, London, SE5 9RS, UK

    Ketul V. Patel, Dean Y. Huang & Paul S. Sidhu

Authors
  1. Ketul V. Patel
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  2. Dean Y. Huang
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  3. Paul S. Sidhu
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Corresponding author

Correspondence to Paul S. Sidhu.

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Patel, K.V., Huang, D.Y. & Sidhu, P.S. Metachronous bilateral segmental testicular infarction: multi-parametric ultrasound imaging with grey-scale ultrasound, Doppler ultrasound, contrast-enhanced ultrasound (CEUS) and real-time tissue elastography (RTE). J Ultrasound 17, 233–238 (2014). https://doi.org/10.1007/s40477-014-0098-1

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  • DOI: https://doi.org/10.1007/s40477-014-0098-1

Keywords

  • Testis
  • Segmental infarction
  • Ultrasonography
  • Contrast-enhanced ultrasound
  • Tissue elastography