Echo color Doppler findings in postpubertal mumps epididymo-orchitis

Objective. To describe echo color Doppler features of mumps epididymo-orchi tis in postpubertal boys and men. Methods. Color Doppler ultrasonographic e xaminations of the scrotum in 12 patients (14-34 years old) with serologica lly proven mumps and symptomatic epididymo-orchitis (pain and scrotal swell ing) were compared with color Doppler ultrasonographic examinations of the scrotum in 10 healthy control subjects. Results. Clinically evident testicu lar involvement was bilateral in 1 patient and unilateral in 11 patients (9 left- and 2 right-sided). Four (33.3%) of 12 patients had swelling and a h eterogeneous echo texture of the epididymis and hydrocele. Two (16.7%) of 1 2 patients had swelling of both the epididymis and didymus of the involved side, with a heterogeneous echo texture of the didymus due to hypoechoic, i rregularly shaped, confluent intraparenchymal areas. Two (16.7%) of 12 pati ents had only unilateral mild hydrocele and no testicular abnormalities. In 4 (33.3%) of 12 cases, B-mode ultrasonographic examination did not show an y testicular abnormalities or hydrocele. Hydrocele was anechoic in 4 cases and multiseptated in 4. In 12 (100%) of 12 patients, color Doppler and powe r Doppler ultrasonography showed hypervascularity in the parenchyma of the affected testicle. In 11 patients, spectral Doppler examination of the arte ries at the testicular hilum showed a significantly lower mean SID resistiv e index (0.54 +/- 0.03; range, 0.48-0.57) on the inflamed side compared wit h the opposite unaffected side (mean, 0.66 +/- 0.04; range, 0.71-0.60) (P < .001). In the patient with bilateral involvement, the mean resistive index values in the right and left testicular arteries were 0.57 and 0.55, respe ctively. The mean resistive index of the 13 inflamed testicles (0.54 0.03; range, 0.48-0.57) was significantly different from the mean resistive index values of the right (0.68 +/- 0.03) and left (0.67 +/- 0.04) testicular ar teries in healthy control subjects (P < .001). The mean resistive index in the 11 unaffected testicles in our patients (0.66 0.04; range, 0.71-0.60) w as not significantly different from the mean resistive index in healthy con trol subjects. Conclusions. Ultrasonographic findings in mumps orchitis are not specific. Echo color Doppler examination is more sensitive than ultras onography alone for revealing testicular inflammation.