CONVENTIONAL COLOR DOPPLER VELOCITY SONOGRAPHY VERSUS COLOR DOPPLER ENERGY SONOGRAPHY FOR THE DIAGNOSIS OF ACUTE EXPERIMENTAL TORSION OF THE SPERMATIC CORD

OBJECTIVE. We compared color Doppler velocity sonography and color Dop pler energy sonography for the diagnosis of spermatic cord torsion in a canine model and determined the degree of torsion necessary to acute ly halt testicular blood flow. MATERIALS AND METHODS. Spermatic cord t orsion was created in five dogs by exposing and rotating the ipsilater al testis 0 degrees, 180 degrees, 270 degrees, 360 degrees, 450 degree s, and 540 degrees. Detorsion followed. The testicles were scanned at each torsion stop using both color Doppler velocity sonography and col or Doppler energy sonography. Doppler parameters were optimized (by ph antom and test scans) and maintained at a tolerable noise level throug hout the experiment. Readers who were unaware of the degree of torsion compared flow in the rotated and contralateral control testes. RESULT S. Flow became undetectable by color Doppler velocity sonography and c olor Doppler energy sonography at 450 degrees in four of five cases an d at 540 degrees in one of five cases. We found no significant differe nce between the velocity and the energy techniques for detecting this absence of flow (p > .05, Wilcoxon test). We found a significant diffe rence in degree of flow for both techniques when comparing controls an d all degrees of torsion combined (p < .006, Mann-Whitney test), but s ignificance was achieved at lesser degrees of torsion with the velocit y technique than with the energy technique (180 degrees and 360 degree s, respectively, Wilcoxon test). CONCLUSION. Color Doppler energy sono graphy was not significantly more sensitive than color Doppler velocit y sonography for the diagnosis of spermatic cord torsion in this model . Complete occlusion of arterial inflow occurred at 450-540 degrees of torsion.