Doppler ultrasound. Key findings in testicular torsion.

Congress:

ECR 2020

Poster Number:

C-06361

Type:

Educational Exhibit

Keywords:

Not applicable, Acute, Diagnostic procedure, Ultrasound-Colour Doppler, Ultrasound, Genital / Reproductive system male, Emergency, Genitourinary

Authors:

C. P. rincon¹, C. bocanegra velasquez², M. I. MENDOZA LLERENA³, C. Puentes³, G. A. Averanga Ticona³, J. Crosta³, Y. P. Narváez Rojas³, L. F. Borrino⁴; ¹pablo nogues/AR, ²Pablo Nogues - Buenos Aires/AR, ³BUENOS AIRES/AR, ⁴Pablo Nogues, Bu/AR

DOI:

10.26044/ecr2020/C-06361

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-06361

Fig. 1: Drawing that shows in A: the normal anatomy of the scrotum, testicles and...

Table 1: Optimization strategies for performing scrotal and testicular Doppler

Fig. 8: Comparative images of both testicles of an adult man. Left testis is painful...

Fig. 12: Case 2: A: 14-year-old patient with left testicular pain of 4 hours evolution....

Fig. 19: Differential Diagnosis: Torsioned testicular appendix. A and B: Oval image in...

Fig. 21: Patient of 25 years old with pain at the left testicle of 24 hours of...

Learning objectives

Describe the early and late ultrasound findings in patients with testicular torsion. Identify clinical data and ultrasound technical isues and utilities to make a proper differential diagnosis. Present clinical cases oftesticular torsion with ultrasound images of our institution.

Background

Testicular torsion (TT) is a frequent cause of acute scrotum especially in young patients. It constitutes a urological emergency and should be treated as soon as possible to preserve testicular viability. If treated within the first 6 hours of initiation of syntoms, the surgery has the possibility of preserving testicular viability between 80-100%. TESTICULAR TORSION: It is the rotation of the testicle on itself, with curling ofthe spermatic cord and the blood vessels, compromising the irrigation of the testicle. - PHYSIOPATHOLOGY: it happens becauseofa weak...

Findings and procedure details

TECHNICALSPECIFICATIONS: - Position: supine. The patient with his hand holds his penis towardsthe abdomen. - Transducer: linear high frequency. 7-10 MHz. The testicles and epididymis should be evaluated, in size, shape, structure and echogenicity. Doppler should be used to verify the presence of intratesticular flows, always comparingwith the contralateral. It must be started on the asymptomatic side, to set normal parameters. - UltrasoundDoppler: they must be optimized to show low flow rates. Includes evaluation in B mode, power and color Doppler, and finally pulse-wave Doppler....

Conclusion

Testicular Doppler Ultrasound plays a fundamental role in early diagnosis of testicular torsion, because many times the patient's clinic it is not enough to differentiate testicular torsion from other causes of acute scrotum. Doppler ultrasound is a study of high availability and low cost and is considered as the gold standard for the diagnosis of testicular torsion. It is important that the radiologist become familiar with ultrasound findings of testicular torsion.

Personal information and conflict of interest

- C. P. Rincon - C. Bocanegra Velasquez -M. I. Mendoza Llerena - C. Puentes - G. A. Averanga Ticona All of the above are diagnostic imaging residents in training - J. Crosta; Chief of Ultrasonography department Mail: [email protected] - Y. P. Narváez Rojas; Resident´s Instructor - L. F. Borrino; Head of Diagnostic imaging department Hospital municipal de trauma y emergencias Dr Federico Abete. Pablo Nogues. Malvinas Argentinas. Buenos Aires. Argentina- nothing to disclose

References

1. Patriquin HB, Yazbeck S, Trinh B, et al. Testicular torsion in infants and children: diagnosis with Doppler sonography. Radiology 1993; 188:781–785. 2. Williamson RC. Torsion of the testis and allied conditions. Br J Surg 1976; 63:465–476. 3. Kühn AL, Scortegagna E, Nowitzki KM, Kim YH. Ultrasonography of the scrotum in adults. Ultrasonography. 2016 Jul;35(3):180-197. 4. De Luis Pastor E, Villanueva M, et al. Ecografía escrotal: perlas, patrones y errores. Actas Urol Esp. 2007;31(8):895-910. 5. Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of...