B-MODE AND COLOR-FLOW DUPLEX ULTRASONOGRAPHY - A USEFUL ADJUNCT IN DIAGNOSING SCROTAL DISEASES

Objective To determine the value of ultrasonography (US) and colour-fl ow duplex ultrasonography (CFD) as routine investigations in the diagn osis of scrotal pathologies. Patients and methods The imaging techniqu es were applied to 215 consecutive patients with scrotal complaints. T he diagnosis of a urologist (D1, made from the patient's history, phys ical examination and laboratory results) and that of the radiologist ( D2, using US and CFD) were compared with the 'gold standard' (D3, the operative findings and course of the disease). The sensitivity and spe cificity of the diagnostic pathways (D1, D2) were determined statistic ally and compared with D3. Results The final diagnoses (D3) were testi cular torsion (13 patients), torsion of the appendix testis (5), epidi dymitis (42). inguinal hernia (7), tumour (11), trauma (9), hydrocele (46), epididymal cyst (37), orchitis (10), varicocele (46) and other d iagnoses (8), Using D1, the urologist missed seven diagnoses, of which one was a patient with a testicular torsion combined with an inguinal hernia, and one a patient with a tumour. Using US and CFD (D2), the r adiologist missed five diagnoses, including one patient with combined testicular torsion and inguinal hernia, Conclusion For the diagnosis o f scrotal disorders, the basic clinical evaluation usually provides th e correct diagnosis, However, US and CFD are useful adjuncts which cau se a minimal burden to the patient and that in most cases will lead to the correct diagnosis, especially with important diagnoses like testi cular torsion, when US and CFD should be performed immediately, If thi s does not provide a clear diagnosis, the patient should be explored s urgically.