Gray scale ultrasound of the scrotum.

Clinical differentiation of the various pathological conditions which affect the scrotal contents can be difficult. The value of gray scale ultrasonography was assessed prospectively in 55 patients (110 testes) with specific clinical presentations and was compared to the reported results of other noninvasive imaging procedures. The homogeneous texture of the testes and the coarser pattern of the epididymal region were normally more clearly separable with gray scale signal processing. In this series, a clear differentiation of the origin of an abnormality was possible in 80% of the cases. A negative sonogram was highly reliable. However, the benefits of scrotal ultrasonography can only be evaluated after consideration of the clinical setting and alternative noninvasive diagnostic modalities.