Scrotum & Testes

1. Introduction 100%

Role of Scrotal Ultrasound
Clinical Indications: Pain, Swelling, Trauma, Infertility
Advantages of High-Frequency Ultrasound
Use in Emergency and Outpatient Settings

2. Anatomy of the Scrotum and Testes 90%

Testis: Tunica Albuginea and Seminiferous Tubules
Epididymis: Head, Body, Tail
Spermatic Cord Components
Tunica Vaginalis and Hydrocele Space
Blood Supply and Venous Drainage

3. Scanning Technique 100%

Patient Positioning and Privacy
Use of High-Frequency Linear Transducer
Longitudinal and Transverse Views of Both Testes
Side-to-Side Comparison
Color and Spectral Doppler Assessment

4. Normal Appearance 80%

Homogeneous Testicular Echotexture
Symmetric Size and Vascularity
Epididymis: Isoechoic to Slightly Hypoechoic
Minimal Physiological Fluid in Tunica Vaginalis

5. Acute Scrotal Pathologies 10%

Torsion
Epididymitis / Orchitis
Trauma

6. Extra-testicular pathology 10%

Inguinal hernia

1. Indirect Inguinal Hernia
2. Direct Inguinal Hernia
3. Pantaloon Hernia
4. Sliding Hernia
5. Incarcerated Hernia
6. Strangulated Hernia
7. Inguinal Lipoblastoma

Spermatic cord pathology

1. Spermatic cord torsion
2. Varicocele (pampiniform plexus dilation)
3. Spermatic cord hydrocele
4. Spermatic cord lipoma
5. Inguinal hernia extending into spermatic cord
6. Spermatic cord hematoma
7. Spermatic cord sarcoma (rhabdomyosarcoma)
8. Funiculitis
9. Spermatic cord cyst
10. Fibromas and leiomyomas of the spermatic cord
11. Metastatic deposits in the spermatic cord
12. Tuberculosis of the spermatic cord (rare)
13. Dilated Inguinal lymphatic channels

Epididymal pathology

1. Epididymitis
2. Epididymo-orchitis
3. Epididymal abscess
4. Chronic epididymitis
5 Granulomatous epididymitis
6. Epididymal cyst
7. Spermatocele
8. Epididymal calcification
9. Epididymal tumors

Adenomatoid tumor

Leiomyoma

Papillary cystadenoma

Malignant tumors (metastasis, sarcoma)

10. Epididymal tuberculosis
11. Post-vasectomy changes in epididymis
12. Epididymal trauma (hematoma, rupture)
13. Epididymal torsion (rare)
14. Congenital absence or hypoplasia of epididymis

Diffuse Thickening/ scrotal wall Enema

1. Scrotal wall cellulitis
2. Acute idiopathic scrotal Edema
3. Scrotal Wall Filariasis
4. Scrotal Wall Hematoma
5. Scrotal wall cavernous hemangioma
6. Scrotal wall Lymphangioma
7. Scrotal wall abscess

Scrotal wall Focal lesion

1. Scrotal Epidermal Inclusion Cysts
2. Trichilemmal cysts of the scrotal wall
3. Scrotal Sebaceous Cysts
4. scrotal Epidermoid cyst
5. Idiopathic scrotal wall calcinosis

Others

Tunica vaginalis cyst
Extra-testicular intra-scrotal Epidermoid cyst
Tunica albuginea cyst
Tunica vaginalis calcification
Peyronie disease (penile fibromatosis/ induration- penis plastica)
Indirect Inguinoscrotal hernia
Spermatic cord Varicocele
Epididymal Cyst
Cystic Spermatocele/spermatocele
Inguinal/Spermatic cord Lipoma
Hematocele
• Scrotal recent hemorrhage
• Scrotal chronic hematoma
Pyocele
Hydrocele
• Scrotal sac hydrocele
• Spermatic cord hydrocele
i. Communicating hydrocele
ii. Funicular hydrocele
ii. Encysted hydrocele
iv. Acquired Hydrocele

7.Intra-testicular pathlgy 30%

1. Enlarged testicle / macroorchidism
2. Microorchidism/Testicular Atrophy
3. Cryptorchidism (testicular agenesis)
4. "Undescended" or "ectopic"
5. Polyorchidisum
6. Testicular sarcoidosis
7. Orchitis
8. Leukemia
9. Epididymo-orchitis
10. Seminomas
11. Non-seminomatous Tumors
12. Microlithiasis
13. Testicular Schistosomiasis
14. Appendages
• Appendix testis
• Appendix Torsion
• Appendix epididymis

8. Interventional & Post-Operative Evaluation 0%

Post-Surgery (Orchidopexy, Orchidectomy)
Scrotal Exploration Follow-up
Biopsy Guidance in Infertility Workup
Prosthesis Assessment and Complications

10. Case-Based Learning and Quiz 0%

Acute Scrotum Case Scenarios
Tumor vs Inflammatory Lesions
Doppler Flow Interpretation
Interactive Image-Based MCQs

CEUS for Liver Tumors

CEUS for Liver Tumors

CEUS for Liver Tumors 0%

1. Introduction to CEUS

Principles of Contrast-Enhanced Ultrasound
Microbubble Contrast Agents (e.g., SonoVue, Definity)
Advantages Over CT/MRI in Liver Imaging
Safety Profile and Contraindications

2. CEUS Phases and Timing

Arterial Phase (10–35 sec)
Portal Venous Phase (30–120 sec)
Late Phase (>2 min)
Wash-in and Wash-out Patterns

3. CEUS in Benign Liver Lesions

Hemangioma: Peripheral Nodular Enhancement
Focal Nodular Hyperplasia (FNH): Central Arterial Fill-in
Hepatic Adenoma: Homogeneous Hyperenhancement
Cyst: No Enhancement

4. CEUS in Malignant Liver Lesions

Hepatocellular Carcinoma (HCC): Arterial Hyperenhancement with Late Washout
Cholangiocarcinoma: Rim Enhancement, Delayed Washout
Liver Metastases: Rapid Washout in Portal Phase
Angiosarcoma: Early Hyperenhancement + Irregular Washout

5. Comparison with Other Modalities

CEUS vs CT for HCC Diagnosis
CEUS in Indeterminate Lesions (LR-3, LR-4 in LI-RADS)
Role in Guiding Biopsies or Ablations

6. Limitations and Pitfalls

Isoenhancing Lesions
Deep or Subdiaphragmatic Lesions
Artifacts: Blooming, Motion
Learning Curve for Interpretation

7. Case Examples and Interpretation

CEUS Pattern Recognition (Benign vs Malignant)
CEUS for Follow-up Post-Treatment (RFA, TACE)
Multiple Case Snapshots with Key Features

8. Quiz and Self-Assessment

Phase Identification Challenge
Spot the Pattern: HCC vs Metastasis
CEUS Diagnosis-Based MCQs

Prostate

1. Introduction 100%

Role of Ultrasound in Prostate Evaluation
Clinical Indications (PSA Elevation, Urinary Symptoms, Cancer Screening)
Comparison with MRI and DRE
Contraindications and Patient Counseling

2. Anatomy of the Prostate 80%

Prostate Zones: Peripheral, Central, Transitional, Anterior Fibromuscular Stroma
Seminal Vesicles and Ejaculatory Ducts
Capsule and Neurovascular Bundles
Relationship to Bladder, Rectum, Urethra

3. Scanning Techniques 100%

Transrectal vs Transabdominal Ultrasound
Patient Preparation and Positioning
Probe Types and Frequencies
Volume Calculation and Prostate Measurements
Use of Color Doppler

4. Normal Prostate Ultrasound Appearance 50%

Echotexture and Size in Different Age Groups
Symmetry and Capsule Definition
Normal Seminal Vesicle Appearance
TRUS Volume Formula: L × W × H × 0.52

5. Prostate Pathologies

1. Benign Conditions

Benign Prostatic Hyperplasia (BPH)
Prostatitis (Acute and Chronic)
Prostatic Calcifications
Prostatic Cysts and Abscesses

2. Malignant Lesions

Suspicious Hypoechoic Lesions in Peripheral Zone
Extracapsular Extension
Seminal Vesicle Invasion
TRUS-Guided Biopsy Indications

3. Post-Procedural Imaging

Post-Biopsy Changes
Follow-up of Ablation or Radiotherapy
Prostatectomy Bed Evaluation (if indicated)

6. Advanced Techniques 0%

Contrast-Enhanced Ultrasound (CEUS) for Cancer Detection
Elastography: Strain and Shear Wave Techniques
TRUS-MRI Fusion for Targeted Biopsy
PI-RADS Overview (MRI Reference and Correlation)

7. Interventional Applications 0%

TRUS-Guided Biopsy Techniques (Systematic & Targeted)
TRUS-Guided Prostatic Abscess Drainage
Fusion Biopsy Planning
Role in Brachytherapy and Focal Therapies

8. Case-Based Learning and Quiz Section 0%

Benign vs Malignant Lesion Examples
Real-World Imaging Challenges
Volume Interpretation Practice
Interactive Image-Based MCQs