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The normal and abnormal scrotum in children: evaluation with color Doppler sonography.
AJR Am J Roentgenol. 1992 Mar; 158(3):613-7.AA

Abstract

The use of color Doppler sonography to evaluate the symptomatic testes in children with scrotal pain or swelling was prospectively studied with a fourth-generation color sonographic unit with a 7-MHz linear transducer. The 32 patients were 1 day to 18 years old (mean age, 8.6 years). Results were correlated with scintigraphic findings in 23 patients, with the final diagnosis established by surgery in 12 patients, and with clinical follow-up in all patients. Eight cases of testicular torsion, including two of acute torsion and six of late torsion, were correctly detected by color Doppler sonography and confirmed surgically. In the remaining patients, perfusion of the testis was correctly detected by color Doppler examination. The final diagnoses in these patients included torsion of the appendix testis (15 patients), epididymitis (five patients), epididymo-orchitis (one patient), yolk sac tumor of the testis (one patient), hydrocele (one patient), and local reaction to an insect bite (one patient). The ability to detect blood flow in the normal contralateral testis was also evaluated in 28 patients. Blood flow was demonstrated in normal testes larger than 1 cm3. Detection of flow in the very small normal prepubertal testis was often difficult, and no flow was identified in one testis. Flow was identified in central arteries in only six of 13 testes smaller than 1 cm3. We conclude that color Doppler sonography is helpful in the initial evaluation of pediatric testes, providing accurate evaluation of the involved hemi-scrotum in our patients and also providing the benefit of both structural and flow information. Until our sensitivity to low-velocity flow improves, we would not suggest the exclusive use of color Doppler sonography in the evaluation of testicular perfusion in the prepubertal patient. We advocate the addition of testicular scintigraphy to corroborate the presence of testicular perfusion when flow in intratesticular arteries cannot be established with certainty by color Doppler sonography.

Authors+Show Affiliations

Department of Radiology Pediatrics, Egleston Children's Hospital, Emory University, Atlanta, GA 30322-1101.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1739005

Citation

Atkinson, G O., et al. "The Normal and Abnormal Scrotum in Children: Evaluation With Color Doppler Sonography." AJR. American Journal of Roentgenology, vol. 158, no. 3, 1992, pp. 613-7.
Atkinson GO, Patrick LE, Ball TI, et al. The normal and abnormal scrotum in children: evaluation with color Doppler sonography. AJR Am J Roentgenol. 1992;158(3):613-7.
Atkinson, G. O., Patrick, L. E., Ball, T. I., Stephenson, C. A., Broecker, B. H., & Woodard, J. R. (1992). The normal and abnormal scrotum in children: evaluation with color Doppler sonography. AJR. American Journal of Roentgenology, 158(3), 613-7.
Atkinson GO, et al. The Normal and Abnormal Scrotum in Children: Evaluation With Color Doppler Sonography. AJR Am J Roentgenol. 1992;158(3):613-7. PubMed PMID: 1739005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The normal and abnormal scrotum in children: evaluation with color Doppler sonography. AU - Atkinson,G O,Jr AU - Patrick,L E, AU - Ball,T I,Jr AU - Stephenson,C A, AU - Broecker,B H, AU - Woodard,J R, PY - 1992/3/11/pubmed PY - 2001/3/28/medline PY - 1992/3/11/entrez SP - 613 EP - 7 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 158 IS - 3 N2 - The use of color Doppler sonography to evaluate the symptomatic testes in children with scrotal pain or swelling was prospectively studied with a fourth-generation color sonographic unit with a 7-MHz linear transducer. The 32 patients were 1 day to 18 years old (mean age, 8.6 years). Results were correlated with scintigraphic findings in 23 patients, with the final diagnosis established by surgery in 12 patients, and with clinical follow-up in all patients. Eight cases of testicular torsion, including two of acute torsion and six of late torsion, were correctly detected by color Doppler sonography and confirmed surgically. In the remaining patients, perfusion of the testis was correctly detected by color Doppler examination. The final diagnoses in these patients included torsion of the appendix testis (15 patients), epididymitis (five patients), epididymo-orchitis (one patient), yolk sac tumor of the testis (one patient), hydrocele (one patient), and local reaction to an insect bite (one patient). The ability to detect blood flow in the normal contralateral testis was also evaluated in 28 patients. Blood flow was demonstrated in normal testes larger than 1 cm3. Detection of flow in the very small normal prepubertal testis was often difficult, and no flow was identified in one testis. Flow was identified in central arteries in only six of 13 testes smaller than 1 cm3. We conclude that color Doppler sonography is helpful in the initial evaluation of pediatric testes, providing accurate evaluation of the involved hemi-scrotum in our patients and also providing the benefit of both structural and flow information. Until our sensitivity to low-velocity flow improves, we would not suggest the exclusive use of color Doppler sonography in the evaluation of testicular perfusion in the prepubertal patient. We advocate the addition of testicular scintigraphy to corroborate the presence of testicular perfusion when flow in intratesticular arteries cannot be established with certainty by color Doppler sonography. SN - 0361-803X UR - https://www.unboundmedicine.com/medline/citation/1739005/The_normal_and_abnormal_scrotum_in_children:_evaluation_with_color_Doppler_sonography_ L2 - https://www.ajronline.org/doi/10.2214/ajr.158.3.1739005 DB - PRIME DP - Unbound Medicine ER -