Gray-Scale and Color Doppler Sonography of Scrotal Disorders in Children: An Update

Aso, Celestino; Enríquez, Goya; Fité, Marta; Torán, Núria; Piro, Carmen; Piqueras, Joaquim; Lucaya, Javier

doi:10.1148/rg.255045109

Cited by 172 publications

(151 citation statements)

References 73 publications

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“…Because, ultrasonography provides excellent anatomic details, dynamic mode, is bed-side available, cheap and lacking of irradiation harms. 15,16 Like in our case, where bed-side US scans visualized the small bowel loop within the semi-scrotum and confirmed the final diagnosis.…”

Section: -2supporting

confidence: 83%

Giant Scrotal Hernia in a Tiny Male Infant

Fette¹

2014

Pediatr Neonatal Nurs Open J

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Inguinal hernia is a common diagnosis in children. A real scrotal hernia is less common and underreported in medical textbooks. In this case a tiny Libyan boy was admitted with a big swelling of the left groin and hemiscrotum. His clinical findings have been mistaken for a longer time, until the definitive diagnosis has been made. During surgery a giant real scrotal hernia has been dissected and successfully repaired. All specific findings in this special case of infant scrotal hernia are discussed in front of a literature review.

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Section: -2supporting

confidence: 83%

Giant Scrotal Hernia in a Tiny Male Infant

Fette¹

2014

Pediatr Neonatal Nurs Open J

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“…In this case, CEUS can facilitate diagnosis by showing a clear difference in the degree of enhancement between the normal and affected side. Similarly, in chronic (missed) torsion, no testis enhancement on CEUS facilitates to interpret weak color Doppler signals when increased vascularity of the peri-testicular tissues occurs (4,12,13). In addition, since CEUS requires no parameter optimization for the detection of slow flow, or flow in small vessels, it may prove easier and faster than color Doppler in the diagnosis of acute testicular torsion (14).…”

Section: Figure 4 -Severe Testicular Trauma A) On Baseline Ultrasounmentioning

confidence: 99%

“…Detection of flow in testes of small children is another challenge for ultrasonography (13). Currently, the key clinical dilemma still remains to avoid surgery, especially in children, when clinical findings are…”

Section: Figure 4 -Severe Testicular Trauma A) On Baseline Ultrasounmentioning

confidence: 99%

“…On the other hand, color Doppler may fail to demonstrate normal flow in testicles with a volume of less than l cc, leading thus to a false positive diagnosis of testicular torsion (13,16). Therefore, CEUS as it is not susceptible to artifacts can, at least theoretically, facilitate the diagnosis of torsion in pediatric patients; however, the safety of SonoVue® in children has not been currently established.…”

Section: Figure 5 -Epididymal Abscess A) Baseline Color Doppler Exammentioning

confidence: 99%

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Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography?

et al. 2009

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Purpose: To present and evaluate the findings of contrast-enhanced ultrasonography (CEUS) in typical cases of acute painful scrotum. Materials and Methods: Nineteen patients aged from 19 to 61 years old were included in the study. All patients underwent grey-scale and color Doppler ultrasonography (US) of the scrotum, followed by imaging after i.v. administration of 2.4 mL of a second generation ultrasound contrast agent (microbubbles of sulphur hexafluoride). Α dedicated, contrast-sensitive technique was used (Contrast Tissue Imaging -CnTI). The diagnosis was confirmed surgically in 6 cases while in the remaining 8 cases it was based on the combination of clinical, imaging and laboratory findings. Results: The final diagnosis was testicular torsion (n = 4), epididymitis (n = 2, one of the cases complicated by abscess), testicular abscess (n = 1), scrotal abscess (n = 1), testicular trauma of varying severity (n = 6). Five out of 19 cases were true negatives: neither clinical examination nor laboratory tests revealed any pathology. CEUS showed complete lack of enhancement in all cases of torsion, permitting a rapid and definitive diagnosis. In the cases of infection complicated by abscesses, CEUS delineated the lesions much better than the combination of B-mode/Color Doppler US. The severely traumatized testicles showed minimal, inhomogeneous or patchy enhancement, while cases of minor trauma showed no significant enhancement defects. Hematomas were presented as non-enhancing lesions. Conclusion: Generally, there was no advantage over Doppler US as has been previously shown. However, CEUS can be used supplementary to traditional Doppler US in the investigation of blunt testicular trauma especially when there is uncertainty in diagnosis after appropriate clinical and radiographic evaluations occurs. Further studies are required to clearly define the indications of this method.

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“…Torsion of the appendages has been diagnosed. In cases of scrotal trauma, management decisions are often based on the ultra-sonographic findings [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Declining Use of Imaging Modalities Preoperatively in Management of Cryptorchidism in Children

Shoukry¹,

Hemimy²

2016

UCMS

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Abstract:Cryptorchidism is characterised by the absence of one or both testes from the scrotum. It is recorded in 30% of preterm compared to 3% in term infants. Different radiological modalities have been adopted preoperatively to localise cryptorchid testes. Ultrasound Scan (USS) is the most widely used imaging modality because of availability and non-invasiveness. However, the role of Magnetic Resonance Imaging (MRI) & Computed Tomography (CT) preoperatively is still unclear. Several studies advocated comparisons between imaging modalities and operative findings. Aim of the study is to perform 35-year literature survey to elucidate trends of imaging studies in investigating cryptorchidism in children. A PubMed search was performed for publications relevant to the pediatric age group, between January 1980 and January 2015. The 35-year search identified a total of 259 articles. Of these, 45 articles that matched the inclusion criteria were retrospective (n = 11), prospective (n = 5) and other related studies (n = 29). Addressed end-points out come: (1) Imaging modality; USS (n = 16), MRI (n = 6) & CT (n = 3); (2) Sensitivity; USS (45%-96%), MRI (55%-86%) & CT (94%); (3) Specificity; USS (25%-100%), MRI (79%-100%) & CT (100%); (4) Accuracy; USS (15%-91%), MRI (52%) & CT (33%-96%); (5) Population size; (n = 838); (6) Patients' age; range (6m-17y). USS has low sensitivity, specificity and accuracy relatively in determining the presence of testes and localisation of their position. Comparatively, MRI has superior role. However, in the presence of examination under anaesthesia and laparoscopic technique, all these modalities are not recommended in investigations preoperatively. Based on the literature review, there is a universal decline trend in performing imaging studies prior to surgery in children with cryptorchidism despite technology improvement.

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Gray-Scale and Color Doppler Sonography of Scrotal Disorders in Children: An Update

Cited by 172 publications

References 73 publications

Giant Scrotal Hernia in a Tiny Male Infant

Giant Scrotal Hernia in a Tiny Male Infant

Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography?

Declining Use of Imaging Modalities Preoperatively in Management of Cryptorchidism in Children

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