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Sonographic Diagnosis of Superior Hemispheric Testicular Infarction

Michael E. Ledwidge1, Daniel K. Lee2, Thomas C. Winter, III1, David T. Uehling2, Carol C. Mitchell1 and Fred T. Lee, Jr.1

1 Department of Radiology, Sonography Section, University of Wisconsin Hospital and Clinics, Box 3252, E3/311 CSC, 600 Highland Ave., Madison, WI 53792.
2 Department of Urology, University of Wisconsin Hospital and Clinics, Madison, WI 53792.



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  		Fig. 1A. —22-year-old man with left lower quadrant pain radiating to left testicle. Sagittal sonogram of enlarged left testicle reveals heterogeneous echotexture of superior pole (asterisk) compared with normal appearance of lower pole.

 


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  		Fig. 1B. —22-year-old man with left lower quadrant pain radiating to left testicle. Sagittal color-flow Doppler sonogram of left testicle corresponding to A shows absence of flow to superior pole (asterisk).

 


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  		Fig. 1C. —22-year-old man with left lower quadrant pain radiating to left testicle. Transverse color-flow Doppler sonogram of superior hemiscrotum reveals that flow in superior pole of left testicle (L) is absent compared with flow in right testicle (R).

 


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  		Fig. 1D. —22-year-old man with left lower quadrant pain radiating to left testicle. Transverse color-flow Doppler sonogram of inferior hemiscrotum shows flow in inferior pole left testicle (L) is hyperemic compared with flow in right testicle (R).

 


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  		Fig. 1E. —22-year-old man with left lower quadrant pain radiating to left testicle. Sagittal color-flow Doppler sonogram of right testicle depicts normal intratesticular vascularity.

 


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  		Fig. 1F. —22-year-old man with left lower quadrant pain radiating to left testicle. Photograph of gross pathologic specimen obtained during surgery on left testicle shows line of demarcation (arrow) between dusky, ischemic upper pole (asterisk) and normal lower pole. Upper pole biopsy site (arrowhead) and normal-appearing epididymis (E) are also visible.

 

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