Reversal of diastolic plateau in partial testicular torsion

Dogra, Vikram S.; Sessions, Annette; Mevorach, Robert A.; Rubens, Deborah J.

doi:10.1002/1097-0096(200102)29:2<105::aid-jcu1007>3.3.co;2-n

Cited by 5 publications

(5 citation statements)

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“…Asymmetry in resistive indices, with decreased diastolic flow or diastolic flow reversal, may be seen. The presence of color or power Doppler signal in a patient with the clinical manifestation of torsion does not exclude torsion (89).…”

Section: Testicular Torsionmentioning

confidence: 49%

Sonography of the Scrotum

Dogra¹,

Gottlieb²,

Oka³

et al. 2003

Radiology

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621

555

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Ultrasonography (US) with a high-frequency (7.5-10-MHz) transducer has become the imaging modality of choice for examination of the scrotum. US examination can provide information valuable for the differential diagnosis of a variety of disease processes involving the scrotum that have similar clinical manifestations (eg, pain, swelling, or presence of mass). The pathologic condition that may be at the origin of such symptoms can vary from testicular torsion to infection to malignancy. The ability of color and power Doppler US to demonstrate testicular perfusion aids in reaching a specific diagnosis in patients with acute scrotal pain. This review covers the anatomy of the scrotum and the scanning protocol for scrotal US, as well as detailed descriptions of disease processes and their US appearances. Newly described conditions such as intratesticular varicoceles and other benign intratesticular cystic lesions are also discussed.

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Section: Testicular Torsionmentioning

confidence: 49%

Sonography of the Scrotum

Dogra¹,

Gottlieb²,

Oka³

et al. 2003

Radiology

Self Cite

621

555

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“…These authors emphasize that Doppler US is a readily available, noninvasive examination without radiation that provides excellent anatomic details to rule out TT so reliably that routine scrotal exploration for acute scrotum is no longer necessary (11,26). Thus, the diagnosis of partial TT can even be made on the basis of spectral waveform analysis by US (6). In another pediatric series, the sensitivity and specificity of color Doppler US to diagnose TT has been found to be 89 % and 90 %, respectively, whereas clinical diagnosis was accurate only in 47% (12).…”

Section: Discussionmentioning

confidence: 99%

Clinical Predictors for Differential Diagnosis of Acute Scrotum

et al. 2004

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Accurate and early diagnosis of acute scrotum is of the utmost importance to avoid testicular loss and/or needless surgery. The aim of this study is to analyze the clinical presentation and physical examination parameters together with the results of imaging studies in order to find out predictors for the differential diagnosis of acute scrotum with special emphasize on testicular torsion (TT). Patients who were treated for acute scrotum in our unit from 1970 up to and including 2000 were reviewed retrospectively. The study group was subdivided into three groups: "testicular torsion (TT)", "torsion of testicular appendage (TTA)", and "epididymoorchitis (EO)" group according to the diagnosis confirmed by radiologic and surgical findings. Presence and/or absence of various parameters related to clinical presentation, physical examination, and results of imaging studies were analyzed by statistical means in each group. One hundred and sixty children with a mean age of 12.2 years formed the study group. The mean duration of symptoms was 15 hours. No significant difference was noted between the three groups with regard to mean age and duration of symptoms. Nuclear scintigraphy and Doppler ultrasound were used as diagnostic aids in 50 and 66 children, respectively. Clinical presentation parameters including the presence of a) previous trauma, b) pain attacks, and c) nausea and vomiting, had the highest sensitivity, specificity, positive and negative predictive values in the TT group and the lowest values in the EO group. In contrast, the EO group had the highest statistical values with regard to presence of dysuria and micturition disorders. Physical examination parameters consisting of a) elevation, b) transverse location of testis, c) anterior rotation of epididymis, and d) absence of cremasteric reflex had the highest statistical values in the TT group. Contrary to this, imaging studies had the highest specificity and positive predictive values in the TTA group and the lowest values in the TT group. Previous history of trauma and pain attacks, presence of nausea and vomiting, and absence of urinary complaints are the main predictors of TT. Elevation and transverse location of testis with an anteriorly rotated epididymis associated with loss of ipsilateral cremasteric reflex strongly indicate TT. Although accuracy of imaging studies is higher for the differential diagnosis of TTA and EO, there is a considerable risk of misdiagnosis. Therefore, differential diagnosis of acute scrotum, particularly TT, still remains a clinical diagnosis, and clinical parameters deserve more importance in surgical decision making.

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“…34 Importantly, torsion is not reliably excluded by the presence of testicular flow, and in cases of high clinical suspicion but presence of testicular flow, follow-up imaging is recommended. 35 In addition, US examination of the acute scrotum pain should include imaging of the spermatic cord. The real time ''whirlpool sign,'' a sudden rotation or spiral twist of the spermatic cord, has been reported to be a sensitive and specific sign of both complete and incomplete torsion.…”

Section: Torsionmentioning

confidence: 96%

Sonographic Findings of Typical and Atypical Scrotal Trauma

Sommers

2015

Ultrasound Quarterly

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This review article illustrates sonographic findings in the setting of accidental and nonaccidental scrotal trauma. Although sonographic findings may be irrespective of the type of trauma, the goals of sonographic evaluation are similar in both atypical and typical mechanisms of scrotal injury. Familiarity with findings such as disruption of testicular integrity or vascularity facilitates prompt diagnosis and plays a critical role in clinical management.

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Reversal of diastolic plateau in partial testicular torsion

Cited by 5 publications

References 0 publications

Sonography of the Scrotum

Sonography of the Scrotum

Clinical Predictors for Differential Diagnosis of Acute Scrotum

Sonographic Findings of Typical and Atypical Scrotal Trauma

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