Scrotal mass Imaging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Imaging studies for scrotal mass include scrotal ultrasound, MRI, and chest x-ray.

Imaging

Scrotal Ultrasound

• Scrotal ultrasound is the imaging modality of choice for scrotal mass.
• The sensitivity of ultrasound in the identification of scrotal mass is very high (100%).
• Scrotal ultrasound can accurately differentiate extratesticular and intratesticular scrotal mass.
• On scrotal ultrasound, the epididymis appears isoe- to slightly hyperechoic compared with the testis.
• The fact to be remembered before performing scrotal ultrasound is to rule out emergency conditions such as testicular torsion, where it would need emergent surgical referral.

MRI

• MRI of scrotum is seldom used for the detection of scrotal mass, as ultrasound is inexpensive, highly accurate, and easy to perform.
• MRI is particularly helpful in differentiating extratesticular solid scrotal masses (lipoma, liposarcoma).
• Findings on MRI suggestive of scrotal mass are tabulated below:

MRI component	Findings
T1	Both testis and epididymis have intermediate signal intensity compared to muscle Hydrocele appears hypointense
T2	Testis is hyperintense compared to muscle Tunica albuginea is hypointense Epididymal head is hypointense compared to testis Hydrocele appears hyperintense

Chest X Ray

Chest x-ray may be performed to detect metastases of scrotal tumor mass to the lungs.