MRI and ultrasound manifestation of testicle epididymal tuberculosis

Objective: To analyze the features of testicular epididymal tuberculosis on ultrasonography and MRI, and to improve the accuracy of imaging diagnosis of testicular epididymal tuberculosis. Methods: Eight patients with testicular epididymal tuberculosis diagnosed by operation and pathology were retrospectively collected. The imaging features on ultrasonography and MRI were analyzed. Results: The ultrasound examination showed that the testicular epididymis was increased and the echo was heterogeneous. There were multiple small, low-echo areas and partial fusion. There were also no echo areas and granular strong echoes. Testicular epididymal tuberculosis showed abnormal signal lesions of on MRI as hypointensity on T₂WI and DWI. At dynamic enhancement arterial phase, the lesions were obviously and continuously enhanced. However, some lesions centers were not enhanced, suggesting tuberculous granuloma. A small number of lesions show hyperintensity on T₂WI, water diffusion was restricted on DWI, and presented single-ring or multi-loop enhancement, suggesting abscess. Conclusion: Testicular epididymal tuberculosis has certain characteristics, especially the tuberculous granuloma, on ultrasonography and MRI. Combining T₂WI, DWI, enhanced scanning, and ultrasound examination can improve the diagnosis accuracy. (authors)