DUPLEX-DOPPLER SONOGRAPHIC EXAMINATIONS OF THE TESTIS IN PREPUBERTAL BOYS

This retrospective study of 143 pediatric patients with unilateral acu te scrotal disease was done to assess the value of duplex Doppler sono graphic examination prior to puberty (110 patients) in comparison to a pubertal group (33 patients) in a pediatric hospital, where the exami nations are done by staff radiologists and radiology residents of vary ing degrees of expertise and experience with Doppler technique. All pa tients seen during an 18 month period were included. The unaffected si de was examined in most patients and served as control. The normal Dop pler shift in the center of the prepubertal testis was found to be 0.2 to 0.5 kHz, when using a 5 MHz duplex Doppler probe. With puberty, th e Doppler shift increased to 0.5 to 1 kHz. Of 18 patients (10 prepuber tal) with testicular torsion, five (three prepubertal) had false-posit ive Doppler shift. In four of these five cases, faulty placement of th e Doppler sample volume cursor was probably the cause. Using a multi-w ay frequency analysis, puberty was found to have no significant influe nce on results of Doppler signal (chi square = 0.1346; P = 0.7137). Du plex Doppler sonographic examination is as useful to rule out testicul ar torsion in prepubertal boys as it is after puberty. Meticulous tech nique is essential. The opposite side should be examined first and ser ves as control for the affected one. Results showing no flow in the ce nter of the diseased testis with positive flow in the unaffected one s hould lead to further clinical action (scintigraphy or surgery).