The Role of Ultrasound in the Management of Scrotal Disorders

the pathological scrotum Conventional high resolution gray-scale ultrasonography is excellent at evaluating scrotal pathology. The particular value of gray-scale ultrasonography is that it may distinguish between intra-testicular and extra-testicular pathology with 90 -99% accuracy (Krone and Carroll, 1985; Narayan et al., 1981). This distinction is of importance as the majority of intra-testicular lesions are malignant whilst extra-testicular lesions tend to be inflammatory, traumatic or benign. Tumours usually appear as discrete hypoechoic or anechoic masses in contrast to inflammatory lesions that appear homogenous and hyperechoic. The limitation of gray-scale is that it does not assess Perfusion, thus restricting its usefulness in cases of suspected torsion. However the recent development of colour Doppler ultrasonography however has overcome this problem allowing both the measurement of blood flow (in colour) in addition to tissue morphology (in gray-scale).