Color Doppler sonography: its real role in the evaluation of children withhighly suspected testicular torsion

The goal of this study was to assess the reliability of color Doppler imagi ng in boys who presented with acute scrotal pain and borderline clinical fi ndings. The second purpose of the study was to evaluate the potential chang e in diagnostic accuracy as a result of employing radiological staff with v arying levels of experience. Thirty-eight consecutive patients with highly suspected testicular torsion were enrolled in this prospective study. Clini cal examination was followed by color Doppler US (7.5-MHz transducer). The staff of radiologists included four residents and three experienced radiolo gists. All patients underwent surgical exploration. All original reports of residents were reviewed by experienced radiologists and sensitivity with s pecificity were determined and compared. Original interpretations of color Doppler imaging yielded sensitivity of 77.8% and specificity of 85%, which changed after review to 88.9 and 90%, respectively. Clinical assessment was accurate only in 47.4%. Agreement between original and retrospective color Doppler diagnosis was obtained in 20 of 23 (86.9%) reviewed cases. Color D oppler US may prevent unnecessary surgery in the cases with conclusive norm al and increased blood flow. In all other situations scrotal exploration sh ould be performed.