PMC9860098_01
The scrotum (A) and color Doppler US findings (B, C) at the time of referral to our hospital. (A) The left scrotum presents with swelling, pain, and tenderness.. (B) The left epididymis is swollen, and the blood flow increases (arrow).. (C) The left testis is swollen, and a wedge-shaped hypoechoic and heterogeneous echo lesion without blood flow is observed locally in the left testis (asterisk). US, ultrasound. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
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Physical examination revealed normal vital signs; however, the left testis and epididymis presented with swelling, pain, and tenderness (Fig. 1A). C-reactive protein level (CRP; 5.8 mg/dL) and a white blood cell (WBC) count (13,100/mul; 77.9% neutrophils). Color Doppler US of the left epididymis revealed swelling and increased blood flow (Fig. 1B). A wedge-shaped hypoechoic and heterogeneous echo lesion without blood flow was observed locally in his left testis; however, his left testis was also swollen (Fig. 1C).
MRI findings of the testes on hospitalization day 2.. On T2-weighted MRI on the transverse plane, a mosaic of high-intensity and low-intensity signals (black arrowhead) is observed in the left testis. The low-intensity signal shows the finding of hemorrhage. The black arrow indicates the left swollen epididymis. The white arrow indicates that the left swollen testis compresses the right testis. MRI, magnetic resonance imaging.
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MRI for assessing the entire left testis on hospitalization day 2 revealed a mosaic of high-intensity and low-intensity signal areas on T2-weighted MRI in the left testis and no obvious testicular tumor in his left testis (Fig. 2).
MRI findings on the transverse plane at 1 week (A, B) and 3 months (C, D) after the STI. (A), (C) show T2-weighted MRI findings. (B), (D) show T1-weighted contrast-enhanced MRI findings. (A) The left testis (white arrowhead) is still swollen, and the infarcted lesion (asterisk) shows a high-intensity signal area. The white arrow indicates the right testis.. (B) A non-enhanced area (asterisk) is surrounded by perilesional rim enhancement (white arrowhead) in the left testis.. (C) The infarcted lesion shrank, and it changed from a high-intensity signal to a low-intensity signal (black arrowhead).. (D) The infarcted lesion is rather enhanced strongly, and blood flow increases (black arrowhead). MRI, magnetic resonance imaging.
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MRI at 1 week and 3 months after the STI revealed no recurrence of STI (Fig. 3A-D).