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Male Genital Tract

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Pediatric Ultrasound

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Abstract

Ultrasound is the preferred imaging modality for evaluating the male gential tract. Normal scrotal anatomy can be readily visualized using grayscale imaging, and Doppler provides valuable additional information regarding blood flow in the setting of pain or palpable abnormality. The prostate gland and seminal vesicles can also be assessed. Contrast-enhanced ultrasound and elastography are useful in assessing tissue vascularity and stiffness in certain conditions affecting the testes and paratesticular structures. In this chapter, imaging techniques, normal development and anatomy, congenital anomalies, inflammatory disorders and tumors of the male genital tract are discussed.

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Abbreviations

AFP:

Alpha-fetoprotein

ALK:

Anaplastic lymphoma kinase

AVM:

Arteriovenous malformation

CEUS:

Contrast-enhanced ultrasound

CT:

Computed tomography

ESUR:

European Society of Urogenital Radiology

HSP:

Henoch-Schönlein Purpura

Ig:

Immunoglobulin

IMT:

Inflammatory myofibroblastic tumor

IV:

Intravenous

LCH:

Langerhans cell histiocytosis

MAG3:

Mercaptoacetyltriglycine

MR:

Magnetic resonance

NF1:

Neurofibromatosis type 1

SWE:

Shear wave elastography

TNM:

Tumor, Node, Metastasis

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Authors and Affiliations

  1. Department of Radiology, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Judy H. Squires

  2. Division of Ultrasound, Department of Radiology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    Harriet J. Paltiel

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Correspondence to Judy H. Squires .

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Editors and Affiliations

  1. Division of Ultrasound, Department of Radiology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    Harriet J. Paltiel

  2. Division of Thoracic Imaging, Department of Radiology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    Edward Y. Lee

Electronic Supplementary Material

Bell clapper deformity in a 13-year-old boy. Transverse grayscale ultrasound cine of the left scrotum from superior to inferior shows a hydrocele with fluid completely encircling the left testis except at its pedicle of attachment. Although there was normal Doppler flow (not shown), cord twisting, and hypoechogenic linear bands suggesting septal edema, both raised concern for intermittent torsion, which was confirmed at the time of surgery (MP4 6174 kb)

Acute testicular torsion in a 16-year-old boy. Cine demonstrates hydrocele completely encircling the testis except at its pedicle attachment, confirming bell clapper deformity, with twisting of the spermatic cord. Linear hypoechoic bands can be seen related to septal edema (MP4 5483 kb)

Testicular rupture in a 16-year-old boy who sustained direct trauma to the left hemiscrotum. Sagittal split-screen cine clip of the left testis with grayscale images on the left and color Doppler images on the right demonstrates abnormal echogenicity and contour of the mid and lower testis with absent flow (MP4 4775 kb)

Direct inguinal hernia in a 1-month-old boy. Sagittal cine clip of the left inguinal canal and upper scrotum shows peristalsis of herniated bowel loops (MP4 6889 kb)

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Squires, J.H., Paltiel, H.J. (2021). Male Genital Tract. In: Paltiel, H.J., Lee, E.Y. (eds) Pediatric Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-030-56802-3_15

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