Ajm. Hendrikx et al., B-MODE AND COLOR-FLOW DUPLEX ULTRASONOGRAPHY - A USEFUL ADJUNCT IN DIAGNOSING SCROTAL DISEASES, British Journal of Urology, 79(1), 1997, pp. 58-65
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.