Acute Scrotum

Testicular artery supplies the testicle

low impedance flow (high diastolic pressures)

Cremasteric and deferential arteries supply the extra-testicular structures

high impedance flow (low diastolic flow)

use 7-10 mhz linear array

use frog leg posture with all but the testes covered

Two Questions

1. Is there intra-testicular flow

2. Is the echo texture of each testicle homogenous & organized or heterogeneous & disorganized (and is it the same as the other)

Visualize each testicle in transverse and longitudinal

Best to use spectral on both arterial and venous flow

when in transverse, you can see both testicles simultaneously

echogenicity normally looks like the liver

Normal flow will just consist of little dots

early torsion will have normal arterial flow and echogenicity, but venous flow will be absent.

late will have edema, so larger with increase echogenicity no flow in testicle at all

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