Doppler sonography in diagnosis of the acute scrotum.

Doppler sonography has been reported to be a reliable technique for diagnosing acute scrotum significantly decreasing the number of unnecessary surgeries. The aim of this paper was to demonstrate the superiority and validity of Doppler sonography over conventional sonography for differential diagnosis of the acute scrotum. In the period from 2002-2004, 300 patients underwent ultrasound examination of the testicles at the Institute of Radiology in Novi Sad. This prospective randomized study included 100 patients, whereas the target group consisted of 50 patients with the diagnosis of the acute scrotum. The control group consisted of 50 patients with the diagnosis of varicocele. The examinations were done using Siemens Versa Pro equipment and 7,5 MHz probes. On the basis of ultrasound examination, the target group was divided into three groups: 1. Inflammation, 2. Torsion, 3. Miscellaneous. Depending on the disease, the accuracy of diagnosis was confirmed by surgery, clinical findings and control sonographic examination. A functional correlation exists between Doppler diagnosis and final diagnosis in the inflammation and torsion. Resistive indexes (RI) were lower in inflammation, because of hyperemia. In cases with intratesticular hyperemia, the average RI was 0,454 and in those with supratesticular hyperemia 0,575. In cases with torsion, only one patient with appendiceal torsion had normal intratesticular blood flow. In diagnostics of the acute scrotum, Doppler sonography is superior over conventional sonography and more precise in differential diagnostics. RI are good quantitative parameters of hyperemia.