Color Doppler US in the evaluation of acute scrotal disease.

Lerner, Robert M.; Mevorach, Robert A.; Hulbert, William C.; Rabinowitz, Ronald

doi:10.1148/radiology.176.2.2195590

Cited by 124 publications

(45 citation statements)

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“…The second case, using color flow Doppler, probably showed the increased peripheral flow described by Lerner and colleagues. 1 We present three cases of torsion of the testicular appendages in adolescents. A solid mass with a variably thick and echogenic border to the side of a normal testicle, in patients with the appropriate clinical history, appears diagnostic.…”

Section: Discussionmentioning

confidence: 98%

Torsion of the testicular appendage. Sonographic diagnosis

Cohen

Shapiro

Haller

et al. 1992

Journal of Ultrasound in Medicine

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Section: Discussionmentioning

confidence: 98%

Torsion of the testicular appendage. Sonographic diagnosis

Cohen

Shapiro

Haller

et al. 1992

Journal of Ultrasound in Medicine

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“…The spectral waveform is variable depending on the severity and duration of torsion. It can have any of the following patterns: (1) absence of a dicrotic notch resulting in a monophasic waveform, (2) increased resistance to arterial flow with a decrease in diastolic flow velocities and reversal of diastolic flow (Figure 4), 3,8 and (3) absence of arterial flow.…”

Section: Testicular Torsionmentioning

confidence: 99%

“…Color, power, and spectral Doppler sonography are extensively used for evaluating patients with a painful scrotum. [1][2][3] Frequency spectrum analysis is an essential element of vascular sonography. Sonographers and sonologists should be familiar with the various subtle variations in spectral waveforms and the enormous amount of information provided by this technique.…”

mentioning

confidence: 99%

Torsion and Beyond

Dogra

Rubens

Gottlieb

et al. 2004

J of Ultrasound Medicine

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Objective. To illustrate how spectral Doppler waveform analysis plays an adjunctive but very definite role in scrotal sonography. Methods. The cases illustrate a variety of testicular disorders that were collected at a referral tertiary care center. Results. Normal and a variety of pathologic conditions of the testes are discussed, along with their signature spectral waveforms. Conclusions. Analysis of the spectral waveform provides important additional information in various scrotal disorders with acute pain. Spectral waveform analysis is critical to diagnosing incomplete torsion when color and power Doppler examinations are indeterminate. Key words: arteriovenous malformation; varicocele; epididymoorchitis; resistive index; spectral Doppler sonography; testis; torsion. onography is the primary modality for evaluating scrotal disorders. Color, power, and spectral Doppler sonography are extensively used for evaluating patients with a painful scrotum. 1-3 Frequency spectrum analysis is an essential element of vascular sonography. Sonographers and sonologists should be familiar with the various subtle variations in spectral waveforms and the enormous amount of information provided by this technique. The purpose of this presentation is to illustrate how spectral waveform analysis plays an adjunctive but very definite role in scrotal sonography. Normal Spectral Doppler CharacteristicsThe spermatic cord contains the testicular artery, the artery to the vas deferens, and the cremasteric artery supplying blood to the testis, epididymis, and scrotal wall, respectively. In descending order, they arise from the abdominal aorta, superior vesicle artery, and inferior epigastric artery. 1,4 Proper interpretation of velocity waveforms requires an understanding of the normal waveform characteristics of a given vessel and of the physiologic status of the circulation subtended by the vessel. The normal spectral waveform of the testicular artery and artery supplying the epididymis is a lowresistance, high-flow pattern (Figure 1), whereas that of the cremasteric artery supplying the scrotal wall has a high-resistance, low-flow pattern (Figure 2). 5,6

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“…If color flow Doppler delineates a circular mass with an hypervascular echogenic rim surrounding a central hypoechoic region, situated near the superior pole of the testicle, this may indicate torsion of an appendix testis with adjacent reactive inflammation. 12,15,16 In some cases, the central hypoechoic region may not be present and echogenicity may vary with time of presentation. 12 Color flow Doppler imaging is not always accurate in distinguishing epididymitis from torsion of the appendix testis.…”

Section: Discussionmentioning

confidence: 99%

Metachronous bilateral torsion of the testicular appendices

Monga

Scarpero²,

Ortenberg³

1999

Int J of Urology

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Background: Torsion of the appendix testis is a common cause of scrotal pain in children and a common cause for surgical exploration of the pediatric scrotum. The first case of metachronous bilateral torsion of the testicular appendices managed by a non-operative approach is reported. Methods/Results: A case report and a computer-assisted review of the literature are presented. Physical findings of a tender, mobile mass over the anterior surface of the testis characterize the presentation. Doppler findings of normal blood flow to the testes with increased flow to the adjacent appendix testis can be utilized as an adjunct to diagnosis. Ultrasonographic findings of a pedunculated mass with a central hypoechoic area at the superior aspect of the testis support the diagnosis. Accurate non-operative diagnosis of torsion of the appendix testis permits successful conservative management with non-steroidal anti-inflammatory agents. Conclusions: Improvements in ultrasonographic and Doppler imaging of torsion of the appendix testis have facilitated the diagnosis of this entity and decreased the need for surgical exploration of the scrotum.

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Color Doppler US in the evaluation of acute scrotal disease.

Cited by 124 publications

References 0 publications

Torsion of the testicular appendage. Sonographic diagnosis

Torsion of the testicular appendage. Sonographic diagnosis

Torsion and Beyond

Metachronous bilateral torsion of the testicular appendices

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