title: Differential diagnosis of focal epididymal lesions with gray scale sonographic, color Doppler sonographic, and clinical features.
abstract: 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.
authors.affiliation: Department of Radiology, Gachon Medical School, Gil Medical Center, Incheon, South Korea.
authors.forename: Dal Mo
authors.initials: DM
authors.lastname: Yang
authors.forename: Sun Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: Ha Na
authors.initials: HN
authors.lastname: Kim
authors.forename: Jee Hee
authors.initials: JH
authors.lastname: Kang
authors.forename: Tae Seok
authors.initials: TS
authors.lastname: Seo
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Hwang
authors.forename: Hyung Sik
authors.initials: HS
authors.lastname: Kim
authors.forename: Hyuni
authors.initials: H
authors.lastname: Cho
mesh_terms: 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