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[High-frequency ultrasonography for diagnosis and differential diagnosis of acute scrotum in children].
Zhonghua Nan Ke Xue. 2016 Nov; 22(11):996-1000.ZN

Abstract

Objective

To analyze the high-frequency ultrasound image features of acute scrotum in children and explore the value of high-frequency ultrasonography in the diagnosis and differential diagnosis of the disease.

METHODS

This retrospective study included 256 children aged 2 days to 14 years undergoing color Doppler ultrasonography at 2 hours to 3 days after onset of acute scrotum. We analyzed the morphology, internal echo and blood supply of the testis in comparison with the clinical and pathological results.

RESULTS

Among the 256 cases, acute testicular torsion was found in 23, of which 16 were treated by complete resection the necrotic testis and the other 7 by surgical reduction of testicular torsion. Ultrasonographically, the involved testes presented different degrees of increase or decrease in volume, with uneven internal echoes, irregular hypoechoic flakes, and testicular hydrocele. Color Doppler flow imaging (CDFI) showed significant blood flow signals around the diseased testes but none within them. Acute testicular appendix torsion was found in 116 cases, in which ultrasonography manifested nodules with round or oval abnormal echoes between the upper pole of the testis and caput epididymidis, first hypoechoic and then gradually increased, heterogeneous internally. CDFI revealed enlarged epididymides and enriched testicular blood flow but no blood flow signals in the nodules. The 103 cases of acute epididymitis were ultrasonographically characterized by varied degrees of swelling of the involved epididymis with uneven internal echoes and rich blood flow signals on CDFI. Six of the cases were diagnosed as acute orchitis, with the ultrasonographic features of testicular swelling and low but uniform internal echoes, with rich blood flow signals on CDFI. Incarcerated inguinal hernia was confirmed in 15 cases, in which ultrasonography revealed intrusion of the hernia into the obviously enlarged scrotal sac with the mesentery and intestine in it, and blood flow visible on CDFI. Acute scrotal wall hematoma and edema was found in 8 cases, with the ultrasonographic characteristics of scrotal wall thickening, with visible blood flow signals on CDFI.

CONCLUSIONS

High-frequency ultrasonography has a high sensitivity and specificity for acute scrotum in children, which can be applied as the first-choice clinical imaging modality and provide reliable evidence for the diagnosis and differential diagnosis of the disease.

Authors+Show Affiliations

Department of Ultrasound,Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.Department of Ultrasound,Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.Department of Ultrasound,Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.Department of Ultrasound,Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.Department of Ultrasound,Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.Department of Ultrasound,Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.Department of Urology, Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

29281207

Citation

Xu, Yun-Feng, et al. "[High-frequency Ultrasonography for Diagnosis and Differential Diagnosis of Acute Scrotum in Children]." Zhonghua Nan Ke Xue = National Journal of Andrology, vol. 22, no. 11, 2016, pp. 996-1000.
Xu YF, Jiang HY, Hu HY, et al. [High-frequency ultrasonography for diagnosis and differential diagnosis of acute scrotum in children]. Zhonghua Nan Ke Xue. 2016;22(11):996-1000.
Xu, Y. F., Jiang, H. Y., Hu, H. Y., Wang, H. R., Geng, T. X., Pan, H. R., & Li, X. X. (2016). [High-frequency ultrasonography for diagnosis and differential diagnosis of acute scrotum in children]. Zhonghua Nan Ke Xue = National Journal of Andrology, 22(11), 996-1000.
Xu YF, et al. [High-frequency Ultrasonography for Diagnosis and Differential Diagnosis of Acute Scrotum in Children]. Zhonghua Nan Ke Xue. 2016;22(11):996-1000. PubMed PMID: 29281207.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [High-frequency ultrasonography for diagnosis and differential diagnosis of acute scrotum in children]. AU - Xu,Yun-Feng, AU - Jiang,Hai-Yan, AU - Hu,Hui-Yong, AU - Wang,Hai-Rong, AU - Geng,Tian-Xiao, AU - Pan,Hua-Rong, AU - Li,Xiao-Xi, PY - 2017/12/28/entrez PY - 2017/12/28/pubmed PY - 2018/4/17/medline KW - KW - high-frequency ultrasound KW - acute scrotum KW - children KW - testicular torsion KW - ultrasonography SP - 996 EP - 1000 JF - Zhonghua nan ke xue = National journal of andrology JO - Zhonghua Nan Ke Xue VL - 22 IS - 11 N2 - Objective: To analyze the high-frequency ultrasound image features of acute scrotum in children and explore the value of high-frequency ultrasonography in the diagnosis and differential diagnosis of the disease. METHODS: This retrospective study included 256 children aged 2 days to 14 years undergoing color Doppler ultrasonography at 2 hours to 3 days after onset of acute scrotum. We analyzed the morphology, internal echo and blood supply of the testis in comparison with the clinical and pathological results. RESULTS: Among the 256 cases, acute testicular torsion was found in 23, of which 16 were treated by complete resection the necrotic testis and the other 7 by surgical reduction of testicular torsion. Ultrasonographically, the involved testes presented different degrees of increase or decrease in volume, with uneven internal echoes, irregular hypoechoic flakes, and testicular hydrocele. Color Doppler flow imaging (CDFI) showed significant blood flow signals around the diseased testes but none within them. Acute testicular appendix torsion was found in 116 cases, in which ultrasonography manifested nodules with round or oval abnormal echoes between the upper pole of the testis and caput epididymidis, first hypoechoic and then gradually increased, heterogeneous internally. CDFI revealed enlarged epididymides and enriched testicular blood flow but no blood flow signals in the nodules. The 103 cases of acute epididymitis were ultrasonographically characterized by varied degrees of swelling of the involved epididymis with uneven internal echoes and rich blood flow signals on CDFI. Six of the cases were diagnosed as acute orchitis, with the ultrasonographic features of testicular swelling and low but uniform internal echoes, with rich blood flow signals on CDFI. Incarcerated inguinal hernia was confirmed in 15 cases, in which ultrasonography revealed intrusion of the hernia into the obviously enlarged scrotal sac with the mesentery and intestine in it, and blood flow visible on CDFI. Acute scrotal wall hematoma and edema was found in 8 cases, with the ultrasonographic characteristics of scrotal wall thickening, with visible blood flow signals on CDFI. CONCLUSIONS: High-frequency ultrasonography has a high sensitivity and specificity for acute scrotum in children, which can be applied as the first-choice clinical imaging modality and provide reliable evidence for the diagnosis and differential diagnosis of the disease. SN - 1009-3591 UR - https://www.unboundmedicine.com/medline/citation/29281207/[High_frequency_ultrasonography_for_diagnosis_and_differential_diagnosis_of_acute_scrotum_in_children]_ DB - PRIME DP - Unbound Medicine ER -