1432: Color Doppler Ultrasound Findings of Intratesticular Varicocele

Abstract

ObjectiveTo study the appearances of the color Doppler ultrasound (CDU) in intratesticular varicocele (ITV) and its pathogenesis and value of clinical application.MethodsA period of three years, 3098 patients with various scrotal diseases were examined by CDU with 10∼14 MHz linear array transductor, analyzed emphatically the appearances of the CDU in ITV, with reviewed the literature.ResultsITV was identified in 1.0% (31/3098) patients with various scrotal diseases, in 2.7% (31/1167) with extratesticular varicocele, and in 8.1%(15/185)with grade III extratesticular varicocele. Of 31 cases, 25 were located in the left testis, 5 in the right, and 1 bilateral. The locations of the ITVs were within the testicular parenchyma in 21, subcapsular in 6, within the mediastinum in 1, mixable in 4. The shapes of the ITVs were serpentine in 15, tubular in 12, oval in 1, and mixable in 4. Diameter ranged from 0.9 to 5.2 mm (mean, 1.6 mm). On CDU, spontaneous retrograde flow was showed in 5 and the retrograde flow could be seen only after the Valsalva maneuver in 27. According to the varication extent of the intratesticular veins, the findings were graded as I∼III stages. The inverse flows of the ITVs were all from ipsilateral pampiniform plexus.ConclusionsITV has a characteristic CDU appearance. With extratesticular varicocele, the rise of the hydrostatic pressure in the pampiniform plexus could not directly result in ipsilateral ITV. The presence of the ITV in extratesticular varicocele may further impair spermatogenesis. ObjectiveTo study the appearances of the color Doppler ultrasound (CDU) in intratesticular varicocele (ITV) and its pathogenesis and value of clinical application. To study the appearances of the color Doppler ultrasound (CDU) in intratesticular varicocele (ITV) and its pathogenesis and value of clinical application. MethodsA period of three years, 3098 patients with various scrotal diseases were examined by CDU with 10∼14 MHz linear array transductor, analyzed emphatically the appearances of the CDU in ITV, with reviewed the literature. A period of three years, 3098 patients with various scrotal diseases were examined by CDU with 10∼14 MHz linear array transductor, analyzed emphatically the appearances of the CDU in ITV, with reviewed the literature. ResultsITV was identified in 1.0% (31/3098) patients with various scrotal diseases, in 2.7% (31/1167) with extratesticular varicocele, and in 8.1%(15/185)with grade III extratesticular varicocele. Of 31 cases, 25 were located in the left testis, 5 in the right, and 1 bilateral. The locations of the ITVs were within the testicular parenchyma in 21, subcapsular in 6, within the mediastinum in 1, mixable in 4. The shapes of the ITVs were serpentine in 15, tubular in 12, oval in 1, and mixable in 4. Diameter ranged from 0.9 to 5.2 mm (mean, 1.6 mm). On CDU, spontaneous retrograde flow was showed in 5 and the retrograde flow could be seen only after the Valsalva maneuver in 27. According to the varication extent of the intratesticular veins, the findings were graded as I∼III stages. The inverse flows of the ITVs were all from ipsilateral pampiniform plexus. ITV was identified in 1.0% (31/3098) patients with various scrotal diseases, in 2.7% (31/1167) with extratesticular varicocele, and in 8.1%(15/185)with grade III extratesticular varicocele. Of 31 cases, 25 were located in the left testis, 5 in the right, and 1 bilateral. The locations of the ITVs were within the testicular parenchyma in 21, subcapsular in 6, within the mediastinum in 1, mixable in 4. The shapes of the ITVs were serpentine in 15, tubular in 12, oval in 1, and mixable in 4. Diameter ranged from 0.9 to 5.2 mm (mean, 1.6 mm). On CDU, spontaneous retrograde flow was showed in 5 and the retrograde flow could be seen only after the Valsalva maneuver in 27. According to the varication extent of the intratesticular veins, the findings were graded as I∼III stages. The inverse flows of the ITVs were all from ipsilateral pampiniform plexus. ConclusionsITV has a characteristic CDU appearance. With extratesticular varicocele, the rise of the hydrostatic pressure in the pampiniform plexus could not directly result in ipsilateral ITV. The presence of the ITV in extratesticular varicocele may further impair spermatogenesis. ITV has a characteristic CDU appearance. With extratesticular varicocele, the rise of the hydrostatic pressure in the pampiniform plexus could not directly result in ipsilateral ITV. The presence of the ITV in extratesticular varicocele may further impair spermatogenesis.