Korean J Urol.  2008 Jun;49(6):574-578.

Segmental Testicular Infarction: Radiologic Diagnosis and Conservative Management

• Jung SG
• Park SW
• Park HJ
• Kim S
• Lee SD

Abstract

Segmental testicular infarction is a rare cause of an acute scrotum. The etiology can be related to sickle cell anemia, hypersensitivity angiitis and polycythemia in some cases, but the condition is usually an idiopathic phenomenon. Because making the differential diagnosis between segmental testicular infarction and testicular tumor can be difficult, most authors have recommended surgery in the past. We report here on cases of testicular segmental infarction that were treated by conservative management and we describe the radiologic findings.

Keyword

Testis; Infarction; Radiology

MeSH Terms

Anemia, Sickle Cell
Diagnosis, Differential
Infarction
Polycythemia
Scrotum
Testis
Vasculitis, Leukocytoclastic, Cutaneous

Figure

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  Fig. 1. Ultrasonography of the left testis. The lesion is hypoechoic, relatively well defined, rather nodular in shape and avascular (arrow).

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  Fig. 2. (A) Magnetic resonance imaging (MRI) of the testis. The T2-weight image shows a relatively well defined lesion on left testis (arrow). (B) MRI of the testis. The T1-weight image shows isointensity with some areas of hyperintensity within left testis, and this is suggestive of hemorrhage (arrow). (C) On the postcontrast T1-weighted MRI, the lesion is hypointense, indicating no uptake of contrast in the lesion, and the borders of the infarct are clearly enhanced (enhancing rim-arrow).

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  Fig. 3. Ultrasonography of the left testis shows complete resolution.

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  Fig. 4. Ultasonography of the right testis. The lesion is a well defined hypoechoic avascular lesion that has a snowman appearance.

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  Fig. 5. (A) On the T1-weighted magnetic resonance imaging (MRI), the lesion is hypointense, indicating no uptake of contrast in the lesion and the borders of the infarct are clearly enhanced. (B) MRI of the testis. The T2 image shows a relatively well defined lesion on the right testis (arrow). (C) The MR diffusion image shows the low signal intensity of the lesion that's due to the decreased diffusion.

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