Segmental testicular infarctions are uncommon testicular lesions that usually result from arterial embolisation or thrombosis (as opposed to testicular infarction from torsion, which may originate from venous occlusion).
The causes of a segmental testicular infarct include:
- focal hypoechoic region in the testis
- wedge-shaped or rounded
- absence of colour Doppler flow in the hypoechoic region
The important differential diagnosis for a focal hypoechoic region in the testicle is a testicular neoplasm. A segmental infarct will show decreased colour Doppler flow, but this requires scrupulous attention to colour Doppler technique. For practical purposes, include both on a differential unless absolutely sure it is not a neoplasm (e.g. it was not present on a study from a couple of days ago).
Also on the differential: