Differential diagnosis of focal epididymal lesions with gray scale sonographic, color Doppler sonographic, and clinical features.
OBJECTIVE
To determine whether focal epididymal lesions can be differentiated on gray scale sonographic, color Doppler sonographic, and clinical features.


METHODS
This was a retrospectiveanalysis of 60 focal epididymal lesions in 57 patients. Focal epididymal lesions were classified into 3 groups: nonspecific epididymitis (n = 43), tuberculous epididymitis (n = 10), and benign epididymal masses (n = 7). The following gray scale sonographic, color Doppler sonographic, and clinical features were analyzed: size, location, echogenicity, and heterogeneity of the lesion; hypoechoic or hyperechoic rim presence; hydrocele presence; degree of blood flow in the lesion; patient's age; duration of symptoms; and scrotal tenderness.


RESULTS
Lesions were larger in patients with tuberculous epididymitis than in those with either nonspecific epididymitis (P = .007) or benign epididymal masses (P = .0017). The hypoechoic or hyperechoic rim of the lesion was more common in patients with benign epididymal masses than in those with nonspecific epididymitis (P = .002). The degree of blood flow in the lesion was greater in patients with nonspecific epididymitis than in those with either tuberculous epididymitis (P = .0019) or benign epididymal masses (P < .001). The duration of symptoms was shorter in patients with nonspecific epididymitis than in those with either tuberculous epididymitis (P < .001) or benign epididymal masses (P = .0092). The frequency of scrotal tenderness was higher in patients with nonspecific epididymitis than in those with either tuberculous epididymitis (P < .001) or benign epididymal masses (P < .001).


CONCLUSIONS
Gray scale sonographic, color Doppler sonographic, and some clinical features may be helpful for differential diagnosis of focal epididymal lesions.
Yang
Dal Mo
DM
Department of Radiology, Gachon Medical School, Gil Medical Center, Incheon, South Korea.
Kim
Sun Ho
SH
Kim
Ha Na
HN
Kang
Jee Hee
JH
Seo
Tae Seok
TS
Hwang
Hee Young
HY
Kim
Hyung Sik
HS
Cho
Hyuni
H
D000328:Adult; D003937:Diagnosis, Differential; D004822:Epididymis / Q000000981:diagnostic imaging*; D004823:Epididymitis / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013733:Testicular Diseases / Q000000981:diagnostic imaging*; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging*; D014389:Tuberculosis, Male Genital / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color