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Urinary Imaging

E2643. Evaluation of Intrascrotal Pathology With Contrast-Enhanced Ultrasound

Brauner N,  Tchelepi H. Keck School of Medicine of USC, Los Angles, CA

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Background Information: The long-standing imaging modality of choice for the evaluation of intrascrotal anatomy and pathology has been ultrasound (US). Over the years, each new advancement in US imaging technology has led to continuous improvement in the diagnosis and characterization of intrascrotal pathology. Modern day conventional US is excellent at detecting intrascrotal lesions, however, in many instances can still have difficulty differentiating between benign and malignant entities. Contrast-enhanced ultrasound (CEUS) is the next step forward in US technology and offers the promise of improved diagnostic accuracy.

Educational Goals/Teaching Points: The aim of this educational exhibit is to briefly review the logistics of performing a CEUS examination, the biophysical properties of ultrasound contrast agents (UCAs). In addition, the CEUS appearance of a spectrum of intrascrotal pathologies will be reviewed, with focus placed on the differentiation between benign and malignant entities using ultrasound contrast enhancement patterns.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Topics to be reviewed include: The nuts and bolts of performing a CEUS examination; the biophysical properties and safety profile of UCAs; CEUS appearance of benign disease including incidental, infectious, and traumatic entities; CEUS appearance of malignant lesions; and the utility of CEUS in tailoring clinical management for indeterminate lesions.

Conclusion: The CEUS examination provides a new tool to the radiologist’s armamentarium that is safe, easy to perform, and offers improve characterization of intrascrotal pathology. This improved characterization may allow for earlier detection of malignancy as well serve to prevent unnecessary orchiectomies for benign entities.