ACCURACY OF DOPPLER SONOGRAPHY IN THE EVALUATION OF ACUTE CONDITIONS OF THE SCROTUM IN CHILDREN

During a 12-month period, 65 boys (newborn to 18 years of age) with ac ute scrotal pain or swelling underwent Doppler sonography of both test es, followed by scintigraphy (15) and/or surgery (34) and close clinic al follow-up for at least 4 months (23). Pulsed Doppler was performed with an ATL UM8 or Quantum II apparatus, using 7.5- or 10-MHz transduc ers. In 25 patients, color Doppler was also used. The testicular arter y was deemed patent if Doppler shifts from branches within the parench yma could be found. (Doppler signals from scrotal or marginal arteries were considered nondiagnostic). Through Surgery, 19 testicular torsio ns were noted. Seventeen were diagnosed as such with Doppler. Two boys with torsion were deemed normal at the time of both Doppler and scint igraphy evaluation. One boy had a second Doppler examination 13 hours later, which showed no flow. The testicle was necrotic at the time of surgery. The second boy had had 8 hours of symptoms and had a viable t estis at the time of surgery. This probably represented intermittent t orsion. In six of the 65 cases, no signals could be found on either si de, and they were deemed technical failures of the test. Doppler sonog raphy was technically successful in 59 of the 65 patients (91%) and yi elded a sensitivity of 89% and specificity of 100%. Comparing the norm al and painful side helped to define technical failures. Pulsed Dopple r with mechanical sector scanners was more sensitive than color Dopple r. Intermittent torsion was missed with both Doppler sonography and sc intigraphy. Although ultrasonography cannot replace clinical judgement , it may be very helpful in unclear cases. Copyright (C) 1994 by W.B. Saunders Company