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Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler

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Abstract

Background

Little attention has been given to the sonographic appearances of the epididymis in testicular torsion.

Objective

To describe the position and morphology of the epididymis in childhood acute testicular torsion when testicular flow is present on color Doppler sonography.

Materials and methods

We studied the sonographic findings in boys with clinically and surgically proven acute testicular torsion who were examined sonographically from May 2013 to May 2014 and who had preserved intratesticular flow on color Doppler sonography. We retrospectively evaluated the sonograms with emphasis on the epididymal findings.

Results

In all nine boys with confirmed torsion but with preserved intratesticular flow on color Doppler sonography, the epididymal head had an unexpected configuration and size, and no close relationship with the upper pole of the testis. In five of these children the spermatic cord appeared twisted on the affected side. In the remaining four boys the spermatic cord appeared straight.

Conclusion

The position and morphology of the head of the epididymis were abnormal in all boys with acute testicular torsion but with preserved testicular flow.

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References

  1. Beni–Israel T, Goldman M, Bar Chaim S et al (2010) Clinical predictors for testicular torsion as seen in the pediatric ED. Am J Emerg Med 28:786–789

    Article  PubMed  Google Scholar 

  2. Gunther P, Schenk JP, Wunsch R et al (2006) Acute testicular torsion in children: the role of sonography in the diagnostic workup. Eur Radiol 16:2527–2532

    Article  CAS  PubMed  Google Scholar 

  3. Altinkilic B, Pilatz A, Weidner W (2013) Detection of normal intratesticular perfusion using color coded duplex sonography obviates need for scrotal exploration in patients with suspected testicular torsion. J Urol 189:1853–1858

    Article  PubMed  Google Scholar 

  4. Pepe P, Panella P, Pennisi M et al (2006) Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? Eur J Radiol 60:120–124

    Article  PubMed  Google Scholar 

  5. Waldert M, Klatte T, Schmidbauer J et al (2010) Color Doppler sonography reliably identifies testicular torsion in boys. Urology 75:1170–1174

    Article  PubMed  Google Scholar 

  6. Karmazyn B, Steinberg R, Kornreich L et al (2005) Clinical and sonographic criteria of acute scrotum in children: a retrospective study of 172 boys. Pediatr Radiol 35:302–310

    Article  PubMed  Google Scholar 

  7. Dogra V, Gottlieb R, Oka M et al (2003) Sonography of the scrotum. Radiology 227:18–36

    Article  PubMed  Google Scholar 

  8. Arce J, Cortés M, Vargas J (2002) Sonographic diagnosis of acute spermatic cord torsion. Rotation of the cord: a key to the diagnosis. Pediatr Radiol 32:485–491

    Article  PubMed  Google Scholar 

  9. Baud C, Veyrac C, Couture A et al (1998) Spiral twist of the spermatic cord: a reliable sign of testicular torsion. Pediatr Radiol 28:950–954

    Article  CAS  PubMed  Google Scholar 

  10. Nussbaum Blask A, Rushton H (2006) Sonographic appearance of the epididymis in pediatric testicular torsion. AJR Am J Roentgenol 187:1627–1635

    Article  PubMed  Google Scholar 

  11. Leung ML, Gooding GA, Williams RD (1984) High-resolution sonography of scrotal contents in asymptomatic subjects. AJR Am J Roentgenol 143:161–164

    Article  CAS  PubMed  Google Scholar 

  12. Schalamon J, Ainoedhofer H, Schleef J et al (2006) Management of acute scrotum in children — the impact of Doppler ultrasound. J Pediatr Surg 41:1377–1380

    Article  PubMed  Google Scholar 

  13. Prando D (2009) Torsion of the spermatic cord: the main gray-scale and Doppler sonographic signs. Abdom Imaging 34:648–661

    Article  PubMed  Google Scholar 

  14. Kalfa N, Veyrac C, Lopez M et al (2007) Multicenter assessment of ultrasound of the spermatic cord in children with acute scrotum. J Urol 177:297–301

    Article  PubMed  Google Scholar 

  15. Bentley DF, Ricchiuti DJ, Nasrallah PF et al (2004) Spermatic cord torsion with preserved testis perfusion: initial anatomical observations. J Urol 172:2373–2376

    Article  PubMed  Google Scholar 

  16. Kalfa N, Veyrac C, Baud C et al (2004) Ultrasonography of the spermatic cord in children with testicular torsion: impact on the surgical strategy. J Urol 172:1692–1695

    Article  CAS  PubMed  Google Scholar 

  17. Cassar S, Bhatt S, Paltiel HJ et al (2008) Role of spectral Doppler sonography in the evaluation of partial testicular torsion. J Ultrasound Med 27:1629–1638

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Agia Sofia Children’s Hospital, Thivon & Papadiamantopoulou, Goudi, 115 27, Athens, Greece

    Paraskevi Galina, Vasiliki Dermentzoglou & Maria Zarifi

  2. Department of General Surgery, Agia Sofia Children’s Hospital, Athens, Greece

    Nikolaos Baltogiannis

Authors
  1. Paraskevi Galina
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  2. Vasiliki Dermentzoglou
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  3. Nikolaos Baltogiannis
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  4. Maria Zarifi
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Correspondence to Paraskevi Galina.

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Galina, P., Dermentzoglou, V., Baltogiannis, N. et al. Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler. Pediatr Radiol 45, 1661–1671 (2015). https://doi.org/10.1007/s00247-015-3375-z

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  • DOI: https://doi.org/10.1007/s00247-015-3375-z

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