Testicular rupture is defined by interruption of the tunica albuginea, with hemorrhage and extrusion of testicular contents into the scrotal sac. The finding of testicular rupture necessitates emergent surgery, as more than 80% can be salvaged if surgery is performed within 72 hours of testicular injury.
US demonstrate a heterogeneous echotexture of the testis, testicular contour abnormality, and disruption of the tunica albuginea. The normal tunica albuginea appears on ultrasound as two parallel hyperechoic lines outlining the testis. In the case shown above, the tunica albuginea is relatively intact in the upper part of the testis, but is lost in the lower part.
Focal hyperechoic or hypoechoic areas in the testicular parenchyma correspond to areas of hemorrhage or infarction. Scrotal wall thickening and hematoceles may also be seen. Color and duplex Doppler images may show decreased or no flow.
References
- Bhatt S, Dogra VS. Role of US in testicular and scrotal trauma. Radiographics. 2008 Oct;28(6):1617-29.
- Deurdulian C, Mittelstaedt CA, Chong WK, Fielding JR. US of acute scrotal trauma: optimal technique, imaging findings, and management. Radiographics. 2007 Mar-Apr;27(2):357-69.
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