Sonography of the Scrotum

In this pictorial essay, we review and discuss the varying morphologic characteristics of scrotal appendages and calculi. Characteristic sonograms obtained from patients with coexisting hydrocele are presented, and recent literature is included. Hydrocele greatly facilitates the imaging of these intrascrotal structures, as it acts as a “water path”. On the one hand, torsion of a scrotal appendage should always be included in the differential diagnosis of acute scrotum, especially in children. On the other hand, scrotolithiasis may occasionally cause mild discomfort. As a consequence, and given the widespread use of sonography for the evaluation of both acute and chronic conditions of the scrotum, radiologists should be familiar with these entities.     

Ultrasound Diagnosis of Carotid Artery Stiffness in Patients with Ischemic Leukoaraiosis

The pathophysiology of ischemic leukoaraiosis (ILA) is unknown. It was recently found that ILA patients have increased aortic stiffness. Carotid stiffness is a more specific parameter and could have value as a non-invasive diagnostic value for ILA. Therefore, using color-coded duplex sonography, we compared local carotid stiffness parameters of 59 patients with ILA with those of 45 well-matched controls. The diagnosis of ILA was based on exclusion of other causes of white matter changes seen on magnetic resonance imaging. Pulse wave velocity β (PWVβ, m/s), pressure–strain elasticity modulus (E_p, kPa), β index and augmentation index (A_ix, %) values were higher and arterial compliance (AC, mm²/kPa) values were lower in the ILA group; however, only E_p and PWVβ reached statistical significance (p ≤ 0.05). β, E_p and PWVβ exhibited an increasing trend with higher Fazekas score, though only E_p reached significance (p = 0.05). The main conclusion was that E_p and PWVβ could have a diagnostic role in patients with ILA.