Learning objectives
To evaluate the role of Contrast-enhanced ultrasound (CEUS) in acute scrotum.
Background
Acute scrotum is a challenging condition that may be caused by a wide spectrum of diseases such as: testicular torsion,
inflammation,
abscess,
infarction,
trauma and neoplasm [1].
Ultrasound (US) with color Doppler (CD) is the imaging investigation of choice for evaluating acute painful scrotal problems [2,3].It is mandatory to differentiate between injuries that require surgical treatment and other conditions that may be managed conservatively.
CEUS is currently considered a reliable imaging technique for the study of tissue perfusion,
and its use in the diagnosis of...
Findings and procedure details
We present our 15 years' experience with patients admitted to our Emergency Department with unclear acute scrotal pain.
Examinations consisted of high-resolution US,
CD at baseline,
low-mechanical index CEUS,
and contrast-enhanced power Doppler (PD).
Both testes were examined to compare their size,
echotexture,
and vascular features.
The examination was extended to the epididymal and funicular structures.
The acoustic contrast agent (Sonovue–Bracco,
Swiss) was administered as a rapid IV bolus (2.4-4.8 mL),
and the line was flushed with 5-10 mL of normal saline.
Images were acquired...
Conclusion
Most testicular abnormalities are adequately detected using US and CD/PD,
also owing to the possibility of comparing with the contralateral testis.
However,
in selected cases of acute scrotum,
especially in partial funicular torsion and testicular trauma,
CEUS may be considered an excellent problem solving technique to obtain clearer diagnostic information.
Personal information
R.
Lobianco,
Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
M.
Di Meo,
Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
G.
Gervasio,
Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
A.
G.
Tucci,
Department of Advanced Biomedical Sciences,
Diagnostic Imaging section,University of Naples "Federico II",
Naples (Italy)
M.
Puglia,
Department of Advanced Biomedical Sciences,
Diagnostic Imaging section,University of Naples "Federico II",
Naples (Italy)
A.
Ragozzino,
Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,...
References
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Burgher SW.
Acute scrotal pain.
Emerg Med Clin North Am 1998; 16:781–809
2.
Bhatt S et al .
Role of US in testicular and scrotal trauma.
RadioGraphics 2008;28:1617-29.
3.
Deurdulian C et al.
US of acute scrotal trauma: optimal technique,
imaging findings,
and management.
Radiographics 2007;27:357e69.
4.
Claudon M et al.
Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) - update 2008.
Ultraschall Med 2008;29:28e44
5.
Valentino M et al.
Role of contrast enhanced ultrasound in acute scrotal diseases.
Eur Radiol....