Absent Blood Flow in the Testis on Color Doppler Ultrasound: The Causes, Differential Diagnosis and Clinical Value
Objectives: To investigate the causes, differential diagnosis, and clinical significance of absent blood flow (ABF) in the testis detected by color Doppler ultrasound (CDU) in acute scrotum.Methods: A total of 263 patients with ABF in the testis detected by CDU in our hospital were reviewed retrospe...
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| Format: | Article |
| Language: | English |
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Editorial Office of Advanced Ultrasound in Diagnosis and Therapy
2020-09-01
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| Series: | Advanced Ultrasound in Diagnosis and Therapy |
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| Online Access: | http://www.journaladvancedultrasound.com:81/fileup/2576-2516/PDF/1597831428385-60183482.pdf |
| _version_ | 1818670964443971584 |
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| author | Shun-Ping Chen, MD, Bin Chen, MD |
| author_facet | Shun-Ping Chen, MD, Bin Chen, MD |
| author_sort | Shun-Ping Chen, MD, Bin Chen, MD |
| collection | DOAJ |
| description | Objectives: To investigate the causes, differential diagnosis, and clinical significance of absent blood flow (ABF) in the testis detected by color Doppler ultrasound (CDU) in acute scrotum.Methods: A total of 263 patients with ABF in the testis detected by CDU in our hospital were reviewed retrospectively. However, only 111 patients who underwent surgery were included in this study. The ultrasonographic features of the testis and paratesticular tissue were analyzed. The surgical or surgical-pathologic results were taken as the reference standard to determine the causes of ABF in the testis.Results: The causes of ABF in the testis were testicular torsion (n = 98, torsion group) and non-testicular torsion related diseases (n = 13, non-torsion group, including 8 testicular rupture, 3 epididymitis-orchitis combination with testicular necrosis, and 2 tumors). Tunica albuginea of the testis, diffuse enlarged epididymis, whirlpool sign, and internal echo of the testis were the better parameters for diagnosing the causes of ABF in the testis detected by CDU. And the accuracies of these approaches were 93.7%, 91%, 83.8%, and 81.1%, respectively. Whirlpool sign had a 100% positive predictive value (PPV), and disrupted tunica albuginea of the testis and diffuse enlarged epididymis each had 100% specificity for predicting testicular torsion. When the ultrasonographic findings were combined with these methods to determine the causes, the accuracy was 96.4% (107/111).Conclusion: ABF in the testis detected by CDU is not always indicative of testicular torsion in acute scrotum; Analyzing ultrasound findings of the testis and paratesticular tissue can help with differential diagnosis of the causes of ABF in the testis and guide clinical decision-making. |
| first_indexed | 2024-12-17T07:16:28Z |
| format | Article |
| id | doaj.art-acdec7833da14a2594a64a9e8bf26481 |
| institution | Directory Open Access Journal |
| issn | 2576-2516 |
| language | English |
| last_indexed | 2024-12-17T07:16:28Z |
| publishDate | 2020-09-01 |
| publisher | Editorial Office of Advanced Ultrasound in Diagnosis and Therapy |
| record_format | Article |
| series | Advanced Ultrasound in Diagnosis and Therapy |
| spelling | doaj.art-acdec7833da14a2594a64a9e8bf264812022-12-21T21:58:53ZengEditorial Office of Advanced Ultrasound in Diagnosis and TherapyAdvanced Ultrasound in Diagnosis and Therapy2576-25162020-09-014322322910.37015/AUDT.2020.190035Absent Blood Flow in the Testis on Color Doppler Ultrasound: The Causes, Differential Diagnosis and Clinical ValueShun-Ping Chen, MD, Bin Chen, MD0a Departments of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, ChinaObjectives: To investigate the causes, differential diagnosis, and clinical significance of absent blood flow (ABF) in the testis detected by color Doppler ultrasound (CDU) in acute scrotum.Methods: A total of 263 patients with ABF in the testis detected by CDU in our hospital were reviewed retrospectively. However, only 111 patients who underwent surgery were included in this study. The ultrasonographic features of the testis and paratesticular tissue were analyzed. The surgical or surgical-pathologic results were taken as the reference standard to determine the causes of ABF in the testis.Results: The causes of ABF in the testis were testicular torsion (n = 98, torsion group) and non-testicular torsion related diseases (n = 13, non-torsion group, including 8 testicular rupture, 3 epididymitis-orchitis combination with testicular necrosis, and 2 tumors). Tunica albuginea of the testis, diffuse enlarged epididymis, whirlpool sign, and internal echo of the testis were the better parameters for diagnosing the causes of ABF in the testis detected by CDU. And the accuracies of these approaches were 93.7%, 91%, 83.8%, and 81.1%, respectively. Whirlpool sign had a 100% positive predictive value (PPV), and disrupted tunica albuginea of the testis and diffuse enlarged epididymis each had 100% specificity for predicting testicular torsion. When the ultrasonographic findings were combined with these methods to determine the causes, the accuracy was 96.4% (107/111).Conclusion: ABF in the testis detected by CDU is not always indicative of testicular torsion in acute scrotum; Analyzing ultrasound findings of the testis and paratesticular tissue can help with differential diagnosis of the causes of ABF in the testis and guide clinical decision-making.http://www.journaladvancedultrasound.com:81/fileup/2576-2516/PDF/1597831428385-60183482.pdf|testicular torsion|epididymitis|ultrasound|color doppler |
| spellingShingle | Shun-Ping Chen, MD, Bin Chen, MD Absent Blood Flow in the Testis on Color Doppler Ultrasound: The Causes, Differential Diagnosis and Clinical Value Advanced Ultrasound in Diagnosis and Therapy |testicular torsion|epididymitis|ultrasound|color doppler |
| title | Absent Blood Flow in the Testis on Color Doppler Ultrasound: The Causes, Differential Diagnosis and Clinical Value |
| title_full | Absent Blood Flow in the Testis on Color Doppler Ultrasound: The Causes, Differential Diagnosis and Clinical Value |
| title_fullStr | Absent Blood Flow in the Testis on Color Doppler Ultrasound: The Causes, Differential Diagnosis and Clinical Value |
| title_full_unstemmed | Absent Blood Flow in the Testis on Color Doppler Ultrasound: The Causes, Differential Diagnosis and Clinical Value |
| title_short | Absent Blood Flow in the Testis on Color Doppler Ultrasound: The Causes, Differential Diagnosis and Clinical Value |
| title_sort | absent blood flow in the testis on color doppler ultrasound the causes differential diagnosis and clinical value |
| topic | |testicular torsion|epididymitis|ultrasound|color doppler |
| url | http://www.journaladvancedultrasound.com:81/fileup/2576-2516/PDF/1597831428385-60183482.pdf |
| work_keys_str_mv | AT shunpingchenmdbinchenmd absentbloodflowinthetestisoncolordopplerultrasoundthecausesdifferentialdiagnosisandclinicalvalue |