Aim and objective: To study the spectrum of sonographic findings of various scrotal swellings and to assess the efficacy of grayscale and color Doppler sonography in the diagnosis of scrotal lesions. Materials and methods: The group under study was comprised of 100 patients of all age groups with acute scrotal pain, painless, or painful scrotal swelling. All patients were scanned with the linear probe on the ultrasound machines GE Voluson S6, Toshiba Xario 100/Toshiba Acuson X 300 from January 2015 to November 2016. Results: There were 128 various sonographic findings in total, at the final diagnosis, as some of the patients had more than one findings. Hydrocele was the most frequent fluid collection, one with the fluid being confined to the tunica vaginalis cavity (92.3%). Varicocele comprised 11% of the total number of cases. At the final diagnosis, there were 11 cases of orchitis (57.1%), some of the patients had more than one of the above three pathologies in different combinations. An incidence of inguinoscrotal hernia was noted in 8%. Conclusion: High-resolution sonography with color Doppler imaging could reliably define the morphological features and vascularity of scrotal lesions. Sonography was highly accurate in evaluating the consistency of scrotal mass—solid or cystic. Color Doppler was found extremely sensitive in the diagnosis and differentiation of testicular torsion and inflammation especially in the case of equivocal grayscale findings. Varicoceles were accurately diagnosed using color Doppler flow imaging (CDFI). The present study concludes that high-resolution sonography should be used as a first-line investigation. CDFI adds useful information and complement grayscale sonography in reaching a quick and correct diagnosis.
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