Scrotum is one of the human body regions best suited to ultrasonographic exploration: accessibility and superficiality of the tissues are particularly adapted to the use of high frequency probes that provide very high quality images containing a large number of anatomical details.
Color Doppler sonography is the first choice of imaging technique to answer clinician questions. Recently, contrast enhanced ultrasound (CEUS) has modified the strategy of imaging, particularly in case of acute ischemic disease or trauma . Furthermore, parametric analysis of CEUS signal may provide complementary information that can be useful to precisely determine the nature of intratesticular focal anomalies. Other new US modalities like elastography or ultrafast Doppler are still under evaluation.
Because of the different scrotal anatomical compartments, scrotal ultrasound need to be systematic and precise with B-mode and color Doppler settings well adjusted.
The use of very high frequency probes (12 to 15 MHz), even if theoretically needed for very thin details and to optimize the detection of vascular signal, must be limited to very superficial structures such as the scrotal wall. Indeed, detection of color Doppler signal can be limited particularly when looking for testicular vessels. So, it is recommended to use a 9 MHz probe with sufficient Doppler sensitivity and better penetration.
The author has no competing interests to declare.
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