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>3.0.co;2-w

Cited by 35 publications

(5 citation statements)

References 7 publications

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“…13,14 Salvageability largely depended on the duration of pain at presentation. Some degree of testicular atrophy was inevitable when pain is present for more than 8 to 12 hours, 15 and when pain was present for more than 24 hours, testicular salvageability was very low. 16 Therefore, even in equivocal cases, early exploration was necessary to prevent testicular loss, and negative explorations were acceptable.…”

Section: Discussionmentioning

confidence: 99%

Acute Scrotum in Children

Yang¹,

Song²,

Liu³

et al. 2011

Pediatric Emergency Care

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Overlap existed between testicular torsion and other acute scrotum. The clinical manifestations, physical examination findings, laboratory, and radiographic data were helpful in distinguishing acute scrotum. Doppler ultrasound is an indispensable imaging modality for the clinical assessment of patients with acute scrotum; in the presence of a clinical suspicion of testicular torsion, even with an apparently normal-color Doppler ultrasound, surgical exploration is still indicated.

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Section: Discussionmentioning

confidence: 99%

Acute Scrotum in Children

Yang¹,

Song²,

Liu³

et al. 2011

Pediatric Emergency Care

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“…The spectral waveform is variable depending on the severity and duration of torsion. It can have any of the following patterns: (1) absence of a dicrotic notch resulting in a monophasic waveform, (2) increased resistance to arterial flow with a decrease in diastolic flow velocities and reversal of diastolic flow (Figure 4), 3,8 and (3) absence of arterial flow.…”

Section: Testicular Torsionmentioning

confidence: 99%

Torsion and Beyond

Dogra

Rubens

Gottlieb

et al. 2004

J of Ultrasound Medicine

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Objective. To illustrate how spectral Doppler waveform analysis plays an adjunctive but very definite role in scrotal sonography. Methods. The cases illustrate a variety of testicular disorders that were collected at a referral tertiary care center. Results. Normal and a variety of pathologic conditions of the testes are discussed, along with their signature spectral waveforms. Conclusions. Analysis of the spectral waveform provides important additional information in various scrotal disorders with acute pain. Spectral waveform analysis is critical to diagnosing incomplete torsion when color and power Doppler examinations are indeterminate. Key words: arteriovenous malformation; varicocele; epididymoorchitis; resistive index; spectral Doppler sonography; testis; torsion. onography is the primary modality for evaluating scrotal disorders. Color, power, and spectral Doppler sonography are extensively used for evaluating patients with a painful scrotum. 1-3 Frequency spectrum analysis is an essential element of vascular sonography. Sonographers and sonologists should be familiar with the various subtle variations in spectral waveforms and the enormous amount of information provided by this technique. The purpose of this presentation is to illustrate how spectral waveform analysis plays an adjunctive but very definite role in scrotal sonography. Normal Spectral Doppler CharacteristicsThe spermatic cord contains the testicular artery, the artery to the vas deferens, and the cremasteric artery supplying blood to the testis, epididymis, and scrotal wall, respectively. In descending order, they arise from the abdominal aorta, superior vesicle artery, and inferior epigastric artery. 1,4 Proper interpretation of velocity waveforms requires an understanding of the normal waveform characteristics of a given vessel and of the physiologic status of the circulation subtended by the vessel. The normal spectral waveform of the testicular artery and artery supplying the epididymis is a lowresistance, high-flow pattern (Figure 1), whereas that of the cremasteric artery supplying the scrotal wall has a high-resistance, low-flow pattern (Figure 2). 5,6

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“…9 Subsequent case reports have shown the usefulness of spectral Doppler sonography in partial testicular torsion. 10,11 We describe 8 cases of partial testicular torsion that were diagnosed on the basis of their color and spectral Doppler patterns.…”

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confidence: 99%