Nonspecificity of the "rim sign" in the scintigraphic diagnosis of missed testicular torsion.

Vieras, Frank; Kühn, Christian

doi:10.1148/radiology.146.2.6294739

Cited by 17 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, USG had a lower rate of accuracy in the diagnosis and differentiation of acute testicular torsion from inflammation and accurate results are highly dependent on operator skill [9]. On radionuclide scrotal scintigraphy, non-viable testis appears as an area of photopenia in the region of the testis; sometimes there may be presence of surrounding rim of hyper-perfusion around the photopenia in cases where infarction is due to missed torsion [6]. However, this rim of activity is non-specific and may also be seen in cases of inflammation with super imposed features such as hydrocele [10].…”

Section: Discussionmentioning

confidence: 99%

“…Doppler ultrasound shows decreased intratesticular blood flow in case of torsion while it is increased in case of inflammation such as epididymitis, [5] whereas testicular scintigraphy shows peripheral pooling of tracer with central photopenic area in case of missed torsion or non-viable testis. This peri-testicular hyperemic rim or BHalo sign^on radionuclide scrotal scintigraphy might be absent in cases of small testis or severe infection/inflammation of the scrotum due to poor anatomical resolution of the gamma camera [6]. In cases with equivocal findings, 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) may help in better characterization of the testicular viability, as 18F-FDG enter the cell by the same transport mechanism as glucose and is phosphorylated by hexokinase to form18F-FDG-6 phosphate, which does not undergo further metabolism.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incremental Role of 18FDG PET/CT in Assessment of Testicular Viability

Krishnaraju

Malik

Kumar

et al. 2018

Nucl Med Mol Imaging

View full text Add to dashboard Cite

Testicular torsion is a common differential diagnosis of acute scrotal pain along with acute epididymo-orchitis, which may lead to testicular non-viability. Doppler ultrasound and testicular scintigraphy are two routinely used modalities for the assessment of testicular viability. However, in some cases, these investigations may prove inadequate in differentiating between the two entities with widely differing management. Here, we present a case of a 52-year-old male with questionable viability of testis, who was investigated initially using testicular scintigraphy and was further subjected to a regional 18F-FDG PET/CT scan, in view of inconclusive findings with the conventional modalities.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incremental Role of 18FDG PET/CT in Assessment of Testicular Viability

Krishnaraju

Malik

Kumar

et al. 2018

Nucl Med Mol Imaging

View full text Add to dashboard Cite

show abstract

“…A frank abscess or a tumor may mimic the appearance of missed torsion. 14 Request for a scrotal scintigraphy in cases of acute scrotal pain always comes-up as an emergency IMJM CONCLUSION Scrotal scintigraphy in an acute scrotum is a feasible procedure to be performed on emergency basis, and it is a valid and reliable test to diagnose testicular torsion when US is doubtful or non conclusive. No specific patient preparation is required.…”

Section: Discussionmentioning

confidence: 99%

Scrotal Scintigraphy in Testicular Torsion: An Experience at a Tertiary Care Centre

Omar¹,

Ms²,

Imran³

2012

imjm

View full text Add to dashboard Cite

Introduction: Accurate diagnosis of testicular torsion is important to avoid serious consequences of any delay in proper management. Objective of this study was to compare performance parameters of scrotal scintigraphy and scrotal ultrasound to correctly and confidently diagnose the etiology of an acute scrotum in university hospital settings. Materials and Methods: This is an observational study with a retrospective analysis of data from July 2004 to March 2009. A total of 21 patients (age three years to 37 years) were referred from Emergency Department for scrotal scintigraphy to rule out testicular torsion. All patients went through a standard protocol for scrotal scintigraphy upon referral to Nuclear Medicine Department. Scrotal ultrasound was performed either before or immediately after the scintigraphy. Results: Confirmation of the diagnosis in all 21 patients was based either on the histopathological report of the surgical specimen (n=7) or through clinical follow up (for conservative treatment; n=14). At presentation, nine patients (43%) had left sided pain, and 12 patients (57%) had right sided pain (p>0.05). Eight patients (38%) were diagnosed to have testicular torsion on scintigraphy; one of them turned out to be false positive (testicular abscess). Sensitivity of scrotal scintigraphy to diagnose testicular torsion was 100%, specificity 93%, negative predictive value (NPV) 100% and positive predictive value (PPV) 88%. Conclusion: Scrotal scintigraphy in an acute scrotum is a feasible procedure to be performed on emergency basis, and it is a valid and reliable test to diagnose testicular torsion when US is doubtful or non conclusive.

show abstract

“…[1] A peri-testicular hyperemic rim on radionuclide scrotal scintigraphy is not pathognomonic of missed testicular torsion. [5] Epididymitis and hydrocele have also been reported to mimic testicular torsion on scintigraphy in adults. [6–8] The present study describes a halo-like appearance on scrotal scintigraphy caused by epididymitis with co-existing hydrocele in a clinical setting, suggestive of testicular torsion in a child.…”

Section: Case Reportmentioning

confidence: 99%