Pdf doppler applications in testicular and scrotal. Testicular vascularity can look symmetrical with the contralateral asymptomatic side with preserved arterial and venous flow and still represent testicular torsion. Transverse scrotum compare echogenicity of testicles. The sonographic features of testicular appendiceal torsion includes a circular mass with variable echogenicity located adjacent to the testis or epididymis fig. Testicular and scrotal ultrasound is the primary modality for imaging most of the male reproductive system.
In medicine, testicular doppler is routinely used to determine the blood flow of the testicular artery, the diagnosis of testicular diseases and the study of spermatogenesis pinggera et al. Doppler ultrasound of the testis in azoospermic subjects. Testicular doppler ultrasound urology associates of central. In this study we performed colour doppler ultrasound of the testis in 12 azoospermic subjects affected by primary testicular pathology four bilateral postorchitis, four postradiotheraphy for cancer, four posttraumatic aged 28.
Cost and quality analysis this typical charge is based on the average charge for hospital services only and is not a guarantee. Color doppler ultrasound us is the modality of choice to differentiate testicular torsion from inflammatory conditions and can thus help in avoiding unnecessary surgical explorations. Doppler color, power doppler y ultrasonido doppler es pectral. Grayscale usg characterizes the lesions as testicular or extratesticular and, with color doppler and power doppler, flow and perfusion can also be assessed. Assessment of the intratesticular resistive index by. Doppler ultrasound is the first line diagnostic method for patients with vascular disease. Ultrasound examination of the scrotum is not complete without the application of colour doppler. Doppler imaging, the sensitivity and specificity of ultrasonography for testicular torsion range from 86% to 93%. Transverse right testicle mid with width measurement 5. The procedure is a mandatory part of the imaging evaluation to confirm the presence or absence of uniform, symmetric vascular perfusion of.
Semen evaluation is used to estimate the testicular function. Since testis vascularization might be critical for the gonad function, selected pulse wave doppler ultrasound parameters were assessed in this study. Testicular grayscale ultrasound is the modality of choice for the imaging evaluation of acute scrotal pain. With this modality, arterial flow is readily detected in the normal spermatic cord and testis but is not seen in the epididymis. In bulls, the spermatozoa present in the ejaculate are the result of a process that begun more than 2 mo earlier, bequeathing a delayed depiction of the actual function of the testis. Knowledge of the normal color doppler appearance and waveform characteristics of the testicular artery should aid in.
Testicular trauma and obstructed hernia can be differentiated by taking history from patient. Physical examination adds only a little information. Testicular and scrotal ultrasound radiology reference. Pulse wave doppler ultrasound of testicular arteries and. Prompt diagnosis remains difficult and testicular salvage rates depends on the interval between symptom onset and the surgical treatment. However, presence of color doppler flow does not exclude torsion as in this case. This estimate from bellin health does not include professional fees for primary care physician, surgeon, anesthesiologist, pathologist, radiologist or any other consulting physician.
Testicular torsion is the most common cause of acute scrotal pain in the prepuberal and adolescent boys and should be foremost in the minds of primary care physicians evaluating these children. Complete torsion is characterized by absence of arterial flow on doppler examination. Testicular torsion is a twisting of the spermatic cord and its contents and is a surgical emergency affecting 3. In medicine we use continuous doppler mode cw and pulsed doppler mode pw in form of spectral doppler, color and power angio. Transverse right testicle mid with pw arterial doppler waveform 7. Chapter 4 scrotal ultrasound bruce r gilbert md phd pc. It depends on doppler effect, consisting in frequency wave changes when transmitter and or receiver are moving. Normally, testicular malignancies, either primary or secondary, demonstrate an increase in colour doppler signal. Role of ultrasound with color doppler in acute scrotum. The author, date and country of publication, patient group studied, study type, relevant outcomes.
Color doppler ultrasound evaluation of testicular blood. Evaluacion ultrasonografica del sindrome escrotal agudo siicsalud. Torsion testicular, reto diagnostico ante una urgencia. Discussion testicular torsion is a surgical emergency. Role of spectral doppler sonography in the evaluation of partial testicular torsion scott cassar, md, shweta bhatt, md, harriet j. The assessment of the testicular resistive index ri by colour doppler ultrasonography cdus is used widely in modern medicine to measure intratesticular blood. The presence of intratesticular flow does not exclude testicular torsion. Color doppler usg of the scrotum has been demonstrated to be useful in the diagnosis of scrotal lesions. Dudea, anca ciurea, angelica chiorean, carolina botarjid dept. Color doppler ultrasonography us is an increasingly important tool in the evaluation of the scrotum, especially in acute scrotal disorders. We believe that color doppler ultrasound is capable of reliably showing the normal testicular arterial anatomy by imaging intraarterial blood flow. Testicular doppler resistive index parameter as predictor. Color doppler us is highly accurate for diagnosing testicular torsion, with recent studies reporting doppler sensitivities of 95100% and specificities of 8595% for testicular torsion diagnosis. Role of spectral doppler sonography in the evaluation of.