SPHP Radiology Protocols

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Scrotum

Scrotal Ultrasound (last updated 08/07/2018)
(last reviewed 02/06/2026)

Testis: Sagittal and transverse views.  Color and duplex Doppler evaluation (assess for orchitis, epididymitis, torsion).  Measure each testis in three dimensions.

Epididymis: Sagittal view, measure epididymal head.


Start exam on RIGHT side.

  1. Four sagittal images of the right testis (lateral, mid, medial).  Measure length and AP.
  2. Two sagittal views right epididymis, one with cradiocaudal measurement
  3. Color Doppler of epididymis
  4. Four transverse images of left testis (upper, mid, lower).  Measure width mid testis.
  5. Pulse/spectral Doppler of left testis.  Ideal to include arterial and venous waveforms.
  6. Repeat steps #1 through 5 for right testis.
  7. Transverse side-by-side color Doppler view including BOTH right and left testis (to compare flow).
  8. Transverse image including both testis to compare echotexture.
  9. Evaluate for varicocele bilaterally using Valsalva maneuver.

Notes:
 
Varocele imaging - do gray scale, color Doppler at rest, color Doppler with Valsalva.  Measure vessel size if appropriate.

Torsion imaging - Color Doppler image transverse showing both testes: compare color flow right vs. left.  Doppler both vein and artery of each testis. 

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