An analysis of clinical outcomes using color Doppler testicular ultrasound for testicular torsion

Linda A. Baker, David Sigman, Ranjiv I. Mathews, Jane Benson, Steven G. Docimo

Research output: Contribution to journalArticle

119 Citations (Scopus)

Abstract

Objectives. To delineate the clinical outcomes of color Doppler ultrasound (US) in the equivocal torsion patient. Methods. From 1992 to 1997, 130 patients (<23 years old) from 2 institutions underwent US imaging using a 7.5-mHz linear transducer to evaluate an acute scrotum equivocal, or of low suspicion, for torsion. The US reports and hospital charts of these patients were retrospectively reviewed. Results. After clinical and radiologic evaluation, torsion was excluded in 110 patients without surgical exploration. In 3 patients, intermittent testicular torsion was diagnosed and in 17 patients, emergent exploration was performed for US diagnosis of testicular torsion. Twenty-five patients (22.7%) were subsequently lost to follow-up. Follow-up of 85 patients with US negative for torsion (mean length of follow-up = 466.9 days) revealed no testicular atrophy in 83. Two patients underwent delayed orchiectomy/contralateral orchiopexy for missed testicular torsion. Of 17 patients with US positive for torsion, 9 underwent orchiectomy for a necrotic torsed testis, 7 viable torsed testes were found, and 1 torsed appendix testis was found. Therefore, color Doppler US for the equivocal acute scrotum yielded a 1% false-positive rate, sensitivity of 88.9%, and specificity of 98.8%. Conclusion. When faced with ruling out testicular torsion, it is necessary to integrate the multiple pieces of patient data, knowing that each piece of data may have inaccuracies. With this in mind, this analysis of outcomes verifies that color Doppler US is an excellent adjunctive study in the clinically real situation in which the clinical evaluation is equivocal or low suspicion.

Original languageEnglish (US)
Pages (from-to)604-607
Number of pages4
JournalPediatrics
Volume105
Issue number3
StatePublished - Mar 2000

Fingerprint

Spermatic Cord Torsion
Doppler Ultrasonography
Color
Testis
Scrotum
Orchiectomy
Orchiopexy
Lost to Follow-Up
Transducers
Atrophy
Ultrasonography

Keywords

  • Acute scrotum
  • Color Doppler sonography
  • Testicular torsion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Baker, L. A., Sigman, D., Mathews, R. I., Benson, J., & Docimo, S. G. (2000). An analysis of clinical outcomes using color Doppler testicular ultrasound for testicular torsion. Pediatrics, 105(3), 604-607.

An analysis of clinical outcomes using color Doppler testicular ultrasound for testicular torsion. / Baker, Linda A.; Sigman, David; Mathews, Ranjiv I.; Benson, Jane; Docimo, Steven G.

In: Pediatrics, Vol. 105, No. 3, 03.2000, p. 604-607.

Research output: Contribution to journalArticle

Baker, LA, Sigman, D, Mathews, RI, Benson, J & Docimo, SG 2000, 'An analysis of clinical outcomes using color Doppler testicular ultrasound for testicular torsion', Pediatrics, vol. 105, no. 3, pp. 604-607.
Baker, Linda A. ; Sigman, David ; Mathews, Ranjiv I. ; Benson, Jane ; Docimo, Steven G. / An analysis of clinical outcomes using color Doppler testicular ultrasound for testicular torsion. In: Pediatrics. 2000 ; Vol. 105, No. 3. pp. 604-607.
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abstract = "Objectives. To delineate the clinical outcomes of color Doppler ultrasound (US) in the equivocal torsion patient. Methods. From 1992 to 1997, 130 patients (<23 years old) from 2 institutions underwent US imaging using a 7.5-mHz linear transducer to evaluate an acute scrotum equivocal, or of low suspicion, for torsion. The US reports and hospital charts of these patients were retrospectively reviewed. Results. After clinical and radiologic evaluation, torsion was excluded in 110 patients without surgical exploration. In 3 patients, intermittent testicular torsion was diagnosed and in 17 patients, emergent exploration was performed for US diagnosis of testicular torsion. Twenty-five patients (22.7{\%}) were subsequently lost to follow-up. Follow-up of 85 patients with US negative for torsion (mean length of follow-up = 466.9 days) revealed no testicular atrophy in 83. Two patients underwent delayed orchiectomy/contralateral orchiopexy for missed testicular torsion. Of 17 patients with US positive for torsion, 9 underwent orchiectomy for a necrotic torsed testis, 7 viable torsed testes were found, and 1 torsed appendix testis was found. Therefore, color Doppler US for the equivocal acute scrotum yielded a 1{\%} false-positive rate, sensitivity of 88.9{\%}, and specificity of 98.8{\%}. Conclusion. When faced with ruling out testicular torsion, it is necessary to integrate the multiple pieces of patient data, knowing that each piece of data may have inaccuracies. With this in mind, this analysis of outcomes verifies that color Doppler US is an excellent adjunctive study in the clinically real situation in which the clinical evaluation is equivocal or low suspicion.",
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