Learning objectives
To illustrate the colour-Doppler US findings in a wide spectrum of acute and nonacute disorders of the scrotum. To show the practical value of colour-Doppler in differential diagnosis of scrotal disease. To make the radiologist aware of all typical and atypical appearances of scrotal disorders as shown with colour- and power-Doppler US.
Background
Colour and power-Doppler imaging techniques are currently used in addition to grey-scale imaging in the assessment of a variety of acute and nonacute, testicular and extratesticular disorders of the scrotum. US study of the scrotum is incomplete if not including evaluation with Doppler techniques.
Imaging findings OR Procedure details
Optimal imaging technique requires maximisation of sensitivity toward slow flow. The following parameters should be employed. High resolution, multifrequency transducer (7 MHz Doppler transmitting frequency), low pulse repetition frequency (750 KHz), low wall filter (50 Hz), high colour gain (immediately below artefact threshold). Normal vascular anatomy includes 1) testicular artery, arising from abdominal aorta and reaching the didimis (with capsular and centripetal branches) 2) cremasteric artery, arising from internal iliac artery and reaching funicle, epididymis, and sometime didimis lower pole 3) deferential artery, arising from...
Conclusion
High-resolution colour-Doppler US is used with increasing frequency in the evaluation of the scrotum and can demonstrate several findings relevant for patient management. Optimal scanner setting is mandatory, since failure to recognise vascular signal may be due to inadequate parameters. Knowledge of main interpretative pitfalls and limitation is mandatory.
References
1) Yang DM, Lim JW, Kim JE, Kim JH, Cho H. Torsed appendix testis: gray scale and color Doppler sonographic findings compared with normal appendix testis. J Ultrasound Med. 2005 Jan;24(1):87-91. 2) Blaivas M, Brannam L. Testicular ultrasound. Emerg Med Clin North Am. 2004 Aug;22(3):723-48. 3) Stehr M, Boehm R. Critical validation of colour Doppler ultrasound in diagnostics of acute scrotum in children. Eur J Pediatr Surg. 2003 Dec;13(6):386-92. 4) Kutlu R, Alkan A, Soylu A, Sigirci A, Dusak A. Intratesticular arteriovenous malformation: color Doppler...
Personal Information
Sandomenico Fabio, Dept of Radiology, INT "Pascale", Naples, Italy. Catalano Orlando, Dept of Radiology, INT "Pascale", Naples, Italy, E-mail
[email protected] Nunziata Antonio, Dept of Radiology, PSI Napoli Est, ASL Napoli 1, Naples, Italy, E-mail
[email protected] Lobianco Roberto, Dept of Radiology, S.Maria delle Grazie Hospital, ASL Napoli 2, Pozzuoli, Italy. De Feo Pasquale, Dept of Radiology, PSI Napoli Est, ASL Napoli 1, Naples, Italy Siani Alfredo, Dept of Radiology, INT "Pascale", Naples, Italy.