Acute scrotal pain in pediatric patients: diagnosis with an innovative Doppler technique (MicroV)

Emergency Radiology volume 28, pages209–214(2021)Cite this article

Abstract

Acute scrotal pain is one of the most frequent symptoms in pediatric patients visited in the Emergency Department. Ultrasonography with color and power Doppler represents the first-line method that clinicians use to carry out the differential diagnosis between spermatic cord torsion and inflammation, but sensitivity and specificity are 63–100% and 97–100%, respectively; this variability may be related to operator’s experience and testis vascular hemodynamics and also to machine performance and patient age. Recent technological innovations have made possible to create a new Doppler mode called ultrasound microvascular imaging. This technique exploits algorithms capable of separating low frequencies of static tissue artifacts from ones of very weak flows. It is known as MicroV (from Esaote) and Superb microvascular imaging (from Toshiba). It provides both macrocirculation vascular maps, as a typical Doppler feature, and microcirculation vascular maps. Furthermore, the use of background subtraction could improve the visibility of small vascular structures. We report a case of a pediatric patient suffering from acute scrotal pain assessed ultrasonographically with this innovative Doppler technique (MicroV) that may give more confidence in detecting testicular vascular signals if compared with traditional Doppler techniques.

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Affiliations

  1. Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Division of Radiology, University of Messina, AOU Policlinico Universitario G. Martino, Via Consolare Valeria 1, 98100, Messina, Italy

    Carmela Visalli, Agostino Tessitore, Federica Genitori & Ignazio Salamone

  2. Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Division of Neuroradiology, University of Messina, AOU Policlinico Universitario G. Martino, Via Consolare Valeria 1, 98100, Messina, Italy

    Enricomaria Mormina

  3. Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico Universitario G. Martino, Via Consolare Valeria 1, 98100, Messina, Italy

    Enricomaria Mormina

  4. Department of Human Pathology in Adults and Developmental age, Division of Pediatric Surgery, University of Messina, AOU Policlinico Universitario G. Martino, Via Consolare Valeria 1, 98100, Messina, Italy

    Pietro Impellizzeri & Salvatore Arena

Authors
  1. Carmela Visalli
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  2. Enricomaria Mormina
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  3. Agostino Tessitore
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  4. Pietro Impellizzeri
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  5. Salvatore Arena
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  6. Federica Genitori
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  7. Ignazio Salamone
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Correspondence to Enricomaria Mormina.

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Visalli, C., Mormina, E., Tessitore, A. et al. Acute scrotal pain in pediatric patients: diagnosis with an innovative Doppler technique (MicroV). Emerg Radiol 28, 209–214 (2021). https://doi.org/10.1007/s10140-020-01812-2

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Keywords

  • Ultrasound
  • Power Doppler
  • Microvascular imaging ultrasound (MicroV)
  • Acute scrotal pain
  • Spermatic cord torsion