Segmental testicular infarction diagnosed using microvascular imaging: a case report

  • KUNICHIKA Hideki
    Department of Diagnostic and Interventional Radiology, Nara Medical University
  • MARUGAMI Nagaaki
    Department of Diagnostic and Interventional Radiology, Nara Medical University
  • ISHIGURO Haruka
    Department of Diagnostic and Interventional Radiology, Nara Medical University
  • TAIJI Ryosuke
    Department of Diagnostic and Interventional Radiology, Nara Medical University
  • NAKAI Yasushi
    Department of Urology, Nara Medical University
  • FUJIMOTO Kiyohide
    Department of Urology, Nara Medical University
  • OKADA Fumi
    Department of Diagnostic Pathology, Nara Medical University
  • TANAKA Toshihiro
    Department of Diagnostic and Interventional Radiology, Nara Medical University
  • HIRAI Toshiko
    Department of General Diagnostic Imaging Center, Nara Medical University

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Other Title
  • Micro-vascular imagingモードによる低流速血流評価が診断に有用であった精巣区域梗塞の1例

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Abstract

<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>

Journal

  • Choonpa Igaku

    Choonpa Igaku 49 (2), 159-164, 2022

    The Japan Society of Ultrasonics in Medicine

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