Color Doppler Sonography in the Diagnosis of Acute Scrotum in Boys

Weber, Donna M.; Rösslein, R; Fliegel, C P

doi:10.1055/s-2008-1072366

Cited by 47 publications

(26 citation statements)

References 10 publications

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“…Because of the prompt availability, low costs, short duration (<30 min) and convenience of this examining method when compared with alternative diagnostic tools such as magnetic resonance imaging (MRI) or scintigraphy, sonography has become the standard examination device in the acute scrotum [19,20]. Despite reports on strongly varying results concerning the reliability for detecting testicular torsion by Doppler sonography [1,17,21], recent studies show an increasing sensitivity of this method [11,12,14,22]. Nevertheless, surgical exploration is still mandatory in uncertain cases.…”

Section: Discussionmentioning

confidence: 99%

“…In the last few years, ultrasound has become the most important examination device in all types of paediatric scrotal pathology [9][10][11][12][13][14][15][16][17][18]. This is mainly due to the excellent imaging of anatomic details and perfusion as well as the advantage of real-time examination.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to careful clinical evaluation, Doppler sonography is increasingly used in the management of patients with suspicion for testicular torsion [4,[7][8][9][10][11][12][13][14]. This can mainly be attributed to the quick technical progress with excellent anatomical imaging and simultaneous portrayal of blood flow [8,10].…”

Section: Introductionmentioning

confidence: 99%

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Acute testicular torsion in children: the role of sonography in the diagnostic workup

et al. 2006

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Acute testicular torsion in children is an emergency and has to be diagnosed urgently. Doppler sonography is increasingly used in imaging the acute scrotum. Nevertheless, in uncertain cases, surgical exploration is required. In this study, we attempted to define the role of Doppler sonography in the diagnostic workup of the acutely painful scrotum. All patients admitted between 1999 and 2005 with acute scrotal pain were included. After clinical assessment, patients were imaged by Doppler sonography with a ''high-end'' instrument. In cases of absent arterial perfusion of the testis in Doppler sonography, surgical exploration was carried out. Patients with unaffected perfusion were followed clinically by ultrasound for up to 2 years. Sixty-one infants and children aged 1 day to 17 years (median: 7.9 years) were included. In 14 cases, sonography demonstrated absent central perfusion, with abnormal parenchymal echogenicity in six. Absence of venous blood flow together with reduction of central arterial perfusion was found in one infant. In these 15 patients, surgical exploration confirmed testicular torsion. Among the other 46 patients, we found four cases with increased testicular perfusion and 27 with increased perfusion of the epididymis. In one infant, a testicular tumour was found sonographically, and orchiectomy confirmed diagnosis of a teratoma. Follow-up examinations of the conservatively treated patients showed good clinical outcome with physiologic central perfusion as well as normal echogenic pattern of both testes. No case of testicular torsion was missed. By means of Doppler sonography, an unequivocal statement regarding testicular perfusion was possible in all cases. The initial Doppler diagnosis was confirmed by operative evaluation and follow-up ultrasound. Testicular torsion can therefore be excluded by correctly performed ultrasound with modern equipment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute testicular torsion in children: the role of sonography in the diagnostic workup

et al. 2006

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“…Ultrasonography and Doppler study have been regarded to be highly reliable and benefi cial in avoiding an unnecessary exploration [12] . However, the role of sonography has been under debate with respect to accuracy, availability, cost, delay in treatment, and as the procedure is operator-dependent [1,13,14] .…”

Section: Discussionmentioning

confidence: 99%

The Acute Scrotum: A Review of 40 Cases

2005

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Objective: To determine the relative importance of clinical presentation, laboratory studies, and ultrasonography in the diagnosis of acute scrotum, and to suggest an effective method of management. Subjects and Methods: Forty patients who were hospitalized between January 2002 and December 2002 for acute scrotum were studied with respect to history, physical examination, blood tests, urine analysis including culture, and scrotal ultrasonography with color Doppler study. Results: Epididymitis (n = 24) was the commonest cause of acute scrotum followed by testicular torsion (n = 11), torsion of testicular appendages (n = 4), and idiopathic scrotal edema (n = 1). Both mean age (40.7 vs. 13.8 years), and average duration of pain at presentation (4.5 days vs. 19.1 h) were higher in patients with epididymitis than in torsion. Onset was usually insidious in epididymitis, sudden in testicular torsion, and variable in torsion of testicular appendages. The majority (87.5%) of patients with epididymitis were managed conservatively. The testis was salvaged in 81.8% of patients with testicular torsion. The accuracy of ultrasonography was only 72.7% in testicular torsion, but was good in epididymitis. Conclusion: Our results show that a careful clinical evaluation, by an experienced examiner, provides the correct diagnosis in acute scrotum rather than ultrasonography. It is of utmost importance to exclude testicular torsion in those who are younger than 16 years and whose pain duration is less than 24 h.

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“…De sensitiviteit en specificiteit van dit echo-onderzoek is in ervaren handen zeer hoog. [21][22][23][24][25] In een latere fase na torsio kan er heterogene echogeniciteit worden waargenomen passend bij weefselnecrose en hemorragische infarcering.…”

Section: 12unclassified