High-resolution sonography is a simple, widely available, inexpensive and non-irradiating, noninvasive, practicable, repeatable, enables rapid evaluation and is widely accepted as the method of choice for screening and diagnosis of spectrum of scrotal pathologies. When color Doppler and power Doppler imaging are added, testicular perfusion can be assessed, [1] which provides valuable information in assessment of the acute painful scrotum in addition to scrotal masses and male infertility. This pictorial essay reviews a spectrum of appearance of common and rare cases scrotal pathologies. Introduction Because of superficial location of scrotum and rapid technological advancements and High-resolution sonography color Doppler provides a very good details of anatomy of the scrotal wall, testis, epididymis and testicular perfusion. It is widely accepted as the method of choice for screening and diagnosis of scrotal diseases. In this pictorial review, sonographic findings of a wide variety of scrotal lesions are presented; imaging findings of intratesticular tumors, benign intratesticular lesions, extra testicular tumors, inflammatory and ischemic lesions, and conditions such as hematoma, inguinal hernia and undescended testis are presented. Materials and Methods All cases were performed using standard USG machine (Philips Envisor CHD, Netherlands USA) equipped with high resolution and colour Doppler linear probe of 7.5-12 MHz. Examination was performed in supine position with a folded towel positioned between the patient’s legs to support the scrotum. Serial transverse and sagittal images of each testis and epididymis are obtained and both testicles are compared in echo texture and colour flow. Normal US Scrotal Anatomy A normal adult testis is oval shaped, measures 5 × 3 × 2 cm in size and has homogeneous and intermediate echogenicity [Fig.1A].
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