Preview

Radiology - Practice

Advanced search

The Role of Doppler Ultrasound in the Diagnosis of Postnatal Testicular Torsion in Children

https://doi.org/10.52560/2713-0118-2021-5-69-81

Abstract

The diagnostic significance of the color Doppler study of testicular blood flow in testicular torsion has been studied for about 40 years, however, the prognostic value of the results obtained is ambiguous, as are the actual imaging capabilities of the technique. Our own experience of 110 observations of testicular torsion in children older than the neonatal period allows us to draw statistically reliable conclusions. Made on equipment premium-class research made it possible to evaluate how visualization intratesticular vascular pattern, and whirpool-sign and submit the primitive model of the actual inversion, explaining the impossibility of rendering whirpool-sign with the greatest tight inversion. The dynamics of testicular blood flow was studied immediately after successful and unsuccessful manual detorsion and in the long term after operative detorsion and orchopexy. The publication contains a brief analysis of the literature and is extensively illustrated.

About the Authors

E. B. Olkhova
Moscow State University of Medicine and Dentistry named after A. I. Evdokimov, Department of Radiology, Ministry of Healthcare of Russia; Moscow Clinical Municipal Children Hospital St. Vladimir, Moscow Healthcare Department
Russian Federation

Olkhova Elena Borisovna, M. D. Med., Professor, Professor of Department of Radiology; the Head of Department of the Ultrasound Diagnostic

9а, ul. Vucheticha, Moscow, 127206, Russia

Phone number: +7 (495) 611-01-77



S. Yu. Borisov
Moscow Clinical Municipal Children Hospital St. Vladimir, Moscow Healthcare Department
Russian Federation

Borisov Sergei Yurievich, Radiologist of Department of Ultrasound Diagnostic

1/3, ul. Rubtsovsko-Dvortsovaya, Moscow, 107014, Russia

Phone number: +7 (499) 268-83-87



M. V. Topolnik
Moscow Clinical Municipal Children Hospital St. Vladimir, Moscow Healthcare Department
Russian Federation

Topolnik Margarita Vladimirovna, Radiologist of Department of Ultrasound Diagnostic

1/3, ul. Rubtsovsko-Dvortsovaya, Moscow, 107014, Russia

Phone number: +7 (499) 268-83-87



A. Yu. Tagirova
Moscow Clinical Municipal Children Hospital St. Vladimir, Moscow Healthcare Department
Russian Federation

Tagirova Anapiche Yuzbegovna, Radiologist of Department of Ultrasound Diagnostic

1/3, ul. Rubtsovsko-Dvortsovaya, Moscow, 107014, Russia

Phone number: +7 (499) 268-83-87



S. V. Zhumasitov
Moscow Clinical Municipal Children Hospital St. Vladimir, Moscow Healthcare Department
Russian Federation

Zhumasitov Salavat Viktorovich, Radiologist of Department of Ultrasound Diagnostic

1/3, ul. Rubtsovsko-Dvortsovaya, Moscow, 107014, Russia

Phone number: +7 (499) 268-83-87



T. V. Mukaseeva
Moscow Clinical Municipal Children Hospital St. Vladimir, Moscow Healthcare Department
Russian Federation

Mukaseeva Tatyana Viktorovna, Radiologist of Department of Ultrasound Diagnostic

1/3, ul. Rubtsovsko-Dvortsovaya, Moscow, 107014, Russia

Phone number: +7 (499) 268-83-87



References

1. Adams Ch. R. M., Del Gaizo A. J. The utility of scrotal ultrasonography in the emergent setting: beyond epididymitis versus torsion. Emerg. Radiol. 2018. V. 25. No. 4. P. 341–348.

2. Afsarlar C. E., Ryan Sh. L., Donel E., Baccam T. H., Jones B., Chandwani B., Au J., Huang G. O., Gonzales E. T., Janzen N., Tu D., Seth A., Roth D. R., Koh Ch. J. Standardized process to improve patient flow from the Emergency Room to the Operating Room for pediatric patients with testicular torsion. J. Pediatr. Urol. 2016. V. 12. No. 4. P. 233.e1–4.

3. Altinkilic B., Pilatz A., Weidner W. Detection of normal intratesticular perfusion using color coded duplex sonography obviates need for scrotal exploration in patients with suspected testicular torsion. J. Urol. 2013. V. 189. No. 5. P. 1853–1858.

4. Bandarkar A. N., Blask A. R. Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis. Pediatr. Radiol. 2018. V. 48. No. 5. P. 735–744.

5. Dowall J. M., Adam A., Gerber L., Enyuma C. O. A., Aigbodion S. J., Buchanan S., Laher A. E. The ultrasonographic «whirlpool sign» in testicular torsion: valuable tool or waste of valuable time? A systematic review and meta-analysis. Emerg. Radiol. 2018. V. 25. No. 3. P. 281–292.

6. Galina P., Dermentzoglou V., Baltogiannis N., Zarifi M. Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler. Pediatr. Radiol. 2015. V. 45 No. 11. P. 1661–1671.

7. Guo X., Sun L., Lei W., Li Sh., Guo H. Management of testicular torsion <360° in children: a single-center, retrospective study // J. Int. Med. Res. 2020. V. 48. No. 4. 300060519895861.

8. Hayn M. H., Herz D. B., Bellinger M. F., Schneck F. X. Intermittent torsion of the spermatic cord portends an increased risk of acute testicular infarction. J. Urol. 2008. V. 180. No. 4. Suppl. P. 1729–1732.

9. Kaye J. D., Shapiro E. Y., Levitt S. B., Friedman St. C., Gitlin J., Freyle J., Palmer L. S. Parenchymal echo texture predicts testicular salvage after torsion: potential impact on the need for emergent exploration. J. Urol. 2008. V. 180. No. 4. Suppl. P. 1733–1736.

10. Materny J., Dymny M., Lesiewska L., Gawrych E. Assessment of the validity of Doppler sonography in the diagnosis of acute scrotum in boys Pomeranian. J. Life Sci. 2015. V. 61. No. 2. P. 163–166.

11. Munden M. M., Williams J. L., Zhang W., Crowe J. E., Munden R. F., Cisek L. J. Intermittent testicular torsion in the pediatric patient: sonographic indicators of a difficult diagnosis // AJR Am. J. Roentgenol. 2013. V. 201. No. 4. P. 912–918.

12. Obi A. O. Intermittent testicular torsion. Niger. J. Clin. Pract. 2017. V. 20. No. 10. P. 1273–1276.

13. Patoulias D., Farmakis K., Kalogirou M., Patoulias I. Transient testicular torsion: from early diagnosis to appropriate therapeutic intervention (a prospective clinical study) // Folia Med. Cracov. 2017. V. 57. No. 2. P. 53–62.

14. Prando D. Torsion of the spermatic cord: the main gray-scale and doppler sonographic signs. Abdom. Imaging. 2009. V. 34. No. 5. P. 648–661.

15. Tian X.-M., Tan X.-H., Shi Q.-L., Wen Sh., Lu P., Liu X., Li X.-L., He D.-W., Lin T., Wei G.-H. Risk Factors for Testicular Atrophy in Children With Testicular Torsion Following Emergent Orchiopexy. Front. Pediatr. 2020. V. 11. No. 8. P. 584796.

16. Vijayaraghavan S. B. Sonographic differential diagnosis of acute scrotum: realtime whirlpool sign, a key sign of torsion. J. Ultrasound. Med. 2006. V. 25. No. 5. P. 563–574.

17. West J. M., Goates A. J., Brown J. A. A 26-Year-Old Male with a 14-Year History of Left Intermittent Testicular Torsion Treated with Self-Manual. Reduction. Curr. Urol. 2018. V. 11. No. 3. P. 166–168.

18. Yu K.-J., Wang T.-M., Chen H.-W., Wang H.-H. The dilemma in the diagnosis of acute scrotum: clinical clues for dif ferentiating between testicular torsion and epididymo-orchitis. Chang. Gung. Med. J. 2012. V. 35. No. 1. P. 38–45.


Supplementary files

Review

For citations:


Olkhova E.B., Borisov S.Yu., Topolnik M.V., Tagirova A.Yu., Zhumasitov S.V., Mukaseeva T.V. The Role of Doppler Ultrasound in the Diagnosis of Postnatal Testicular Torsion in Children. Radiology - Practice. 2021;(5):69-81. (In Russ.) https://doi.org/10.52560/2713-0118-2021-5-69-81

Views: 684


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2713-0118 (Online)