Segmental testicular infarction diagnosed using microvascular imaging: a case report

KUNICHIKA Hideki, MARUGAMI Nagaaki, ISHIGURO Haruka, TAIJI Ryosuke, NAKAI Yasushi, FUJIMOTO Kiyohide, OKADA Fumi, TANAKA Toshihiro, HIRAI Toshiko

doi:10.3179/jjmu.jjmu.a.216

<p>Ultrasonography is a clinically essential diagnostic method for evaluating scrotal and intrascrotal structures such as the testis and epididymis. Since segmental testicular infarction is rare and clinically nonspecific, the role of radiological diagnosis is important. However, it is often difficult to distinguish segmental testicular infarction from testicular tumors. In this report, we describe a case of segmental testicular infarction in which low-flow vascularity was depicted using microvascular imaging (MVI). The patient was a male in his 60s. He presented with transient scrotal pain and left scrotal swelling. Ultrasonography showed a wedge-shaped hypoechoic area without color representation and a marginal hyperechoic area with slight blood flow only on MVI in the left testis. The left testis showed easy rotation of about 180 degrees and a small amount of fluid accumulation in the left scrotum. Magnetic resonance imaging showed a wedge-shaped low-signal area on T2-weighted imaging. The lack of blood flow and the flat/wedge-shaped morphology were atypical for testicular tumors, and segmental testicular infarction was suspected. The possibility of testicular infarction due to intermittent testicular torsion was considered based on the easily rotated background of the left testis, and a mild elevation of tumor marker (alpha-fetoprotein) was observed, which led to high-level testicular resection. The patient was diagnosed with segmental testicular infarction histopathologically.</p>

Segmental testicular infarction diagnosed using microvascular imaging: a case report

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