TESTICULAR TORSION IN INFANTS AND CHILDREN - DIAGNOSIS WITH DOPPLER SONOGRAPHY

The accuracy of Doppler sonography in the evaluation of testicular tor sion was tested in 65 boys (aged 0-18 years) with acute scrotal pain o r swelling. All patients underwent pulsed Doppler sonography of both t estes, followed by scintigraphy (n = 16) and/or surgery (n = 34) and a close clinical follow-up for 4-8 months (n = 31). Color Doppler sonog raphy was performed in 29 patients. The testicular artery was deemed p atent if Doppler shifts from branches within the parenchyma could be f ound. Surgery revealed 19 cases of testicular torsion, 17 of which wer e diagnosed with Doppler sonography. There were six technical failures , in which no signals could be found on either side. In four boys, no color signals were obtained in either testis but subsequent examinatio n with a mechanical sector scanner and pulsed Doppler sonography yield ed arterial signals. Doppler sonography was successful in 59 of 65 boy s (91%) and yielded a sensitivity of 89% and specificity of 100%. Puls ed Doppler sonography with mechanical sector scanners was more sensiti ve than color Doppler sonography. Intermittent torsion was missed both with Doppler sonography and scintigraphy.