Role of Grayscale and Color Doppler Ultrasonography in the Diagnosis and Outcome Analysis of Testicular Torsion

Abstract

Ultrasonography (US) plays an important role in helping to differentiate acute epididymo-orchitis from testicular torsion, which is a surgical emergency. Both manifest with acute pain and swelling. Clinical differentiation of these conditions is difficult, with a false-positive rate of nearly 50%, and can result in unnecessary surgical exploration. The purpose of this study was to diagnose and analyze outcomes in patients with suspected testicular torsion by using grayscale and color Doppler US. A total of 15 patients with the final diagnosis of testicular torsion confirmed at operation were retrospectively reviewed. Eleven of the 15 underwent grayscale and color Doppler US imaging using a high frequency linear transducer. The four patients who did not undergo US were excluded. All of the US images were analyzed and compared with operating and pathologic results. Color Doppler US revealed a lack of intratesticular blood flow in the affected testis and normal flow within the contralateral testis in all 11 patients. Grayscale US findings varied, and it was found that all three salvage testes appeared homogeneous or had a slightly increased testicular echogenicity on grayscale US. Color Doppler and grayscale US accurately assesses testicular torsion and can reflect the outcome of the affected testis.