The Role of Technetium-99m Pertechnetate Radionuclide Imaging in the Differentiation Between Acute Testicular Torsion and Inflammatory Testicular Diseases

Abstract

Background: Torsion of the testes is an urological emergency. This clinical condition requires early diagnosis and prompt surgical treatment for testicular survival; however, the early differential diagnosis of acute testicular torsion is often difficult. The aim of this retrospective study was to evaluate the value of technetium-99m pertechnetate radio nuclide imaging in the differentiation between acute testicular torsion and inflammatory testicular diseases. Methods: Thirty male patients (age range: 5-42 years) with suspected acute testicular torsion were enrolled in this stud y between Jul y 1999 and Jul y 2001. Radionuclide imaging was performed after intravenous injections of5-15mCi of technetium-99m pertechnetate in the forearms. Then, all of the patients with clinically suspected acute testicular torsion underwent surgery. Surgical findings and pathology reports of these patients were reviewed and definite diagnoses were made. All of the patients who did not receive operation were followed up clinically for at least one month after radionuclide imaging. Results: Eight patients with testicular torsion,18 patients with inflammatory testicular diseases, and 4 normal subjects were diagnosed by surgical findings, pathological results and/or clinical follow-up. All were accurately diagnosed by technetium-99m pertechnetate radionuclide scrotal imaging. No scintigraphy-related discomfort or side-effects were observed in any of the patients during the study. Conclusions: Our results conclude that technetium-99m pertechnetate radionuclide scrotal imaging is a useful and accurate imaging modality in the differentiation between acute testicular torsion and inflammatory testicular diseases in patients with acute scrotum.