Nuclear Imaging in the Pediatric Acute Scrotum

Valvo, John R.; Caldamone, Anthony A.; O’Mara, Robert E.; Rabinowitz, Ronald

doi:10.1001/archpedi.1982.03970450073018

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…Acute scrotum is often a major diagnostic problet The decision whether to operate or not is taken on t basis of clinical judgement facilitated by more sophis cated tests like radionuclear scans and Doppler ult sound when and where available [7,8,4]. Usually, 1 patients are seen by junior medical staff and under pr sure of time.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings of 66% unnecessary explorations in prepubertal children warrants special consideration in this age group. In this group, the use of radionuclear scans and/or Doppler ultrasound to facilitate the clinical diag nosis [7,8] may be justified despite the prolongation of the interval between the onset of torsion and surgical detorsion in view of the high incidence of unnecessary surgical interventions. When these studies are inconclu sive, surgical exploration should be performed with no further delay.…”

Section: Discussionmentioning

confidence: 99%

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Etiology of Acute Scrotum at Surgical Exploration in Children, Adolescents and Adults

Ben‐Chaim

Leibovitch²,

Ramon³

et al. 1992

Eur Urol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Etiology of Acute Scrotum at Surgical Exploration in Children, Adolescents and Adults

Ben‐Chaim

Leibovitch²,

Ramon³

et al. 1992

Eur Urol

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Reliability of radionuclide scintigraphy for detection of testicular torsion: an animal study

Ahmad

Chheda

et al. 1990

Eur J Nucl Med

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Sodium pertechnetate Tc99m scintigraphy is a valuable technique for the evaluation of acute testicular torsion in postpubescent males. However, in neonates and children with small testicles, the method is less reliable. Since the testicles of adult rats and young children are of similar size, the reliability of testicular imaging for detecting torsion was evaluated in this species. The utility of the radionuclide angiogram (RA) and static images were determined in 17 anesthetized animals before, 2 h after and 20 h after ligation of the left spermatic cord. The preligation RA was asymmetric in 27% of animals, while the static images were abnormal in 18%. Postligation flow and static images were abnormal in 57% and 82% of the animals (localized to the correct side, 38% and 36%), respectively. The animals with vascular occlusion failed to show any statistically significant greater incidence of decreased radionuclide accumulation on the ligated side. To determine the influence of relative perfusion and extracellular fluid space of the scrotum and testicles on the images, additional studies were performed with 201Tl (representing perfusion) and 99mTcO4- (representing ECF space). Perfusion was approximately equal in the testis and epididymis but significantly higher in the scrotum. These results suggest that scrotal scintigraphy is unreliable for detecting acute torsion of small testicles.

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