A Doppler ultrasound (US) of the scrotum is commonly used to improve the diagnostic confidence for testicular torsion in an emergency setting. However, the sensitivity of this investigation to identify torsion varies largely.
This is due, in part, to a lack of guidelines on how-to perform the US and therefore training is necessary.
The Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology (ESUR-SPIWG) and the Section of Urological Imaging of the European Association of Urology (ESUI) established a joint panel of experts to standardize Doppler US investigation of patients with testicular torsion. The panel reviewed the available literature, identified accumulated knowledge and limitations, and released recommendations on how-to perform Doppler US in patients with acute scrotal pain.
Diagnosis of testicular torsion is based on clinical evaluation and investigation of the cord, the testis, and the paratesticular structures. A preliminary clinical evaluation, including history and palpation, is necessary. Grey scale US, color Doppler US and spectral analysis must be performed by a sonologist with at least level 2 competence. Modern equipment with adequate grey-scale and Doppler capabilities are required.
Standardization of Doppler US in suspicious testicular torsion is presented, with the aim to obtain comparable results among different centres, prevent unnecessary operations, and improve patient management.
Minerva urology and nephrology. 2023 Mar 20 [Epub ahead of print]
Michele Bertolotto, Georg Salomon, Nicola Pavan, Pasquale Martino, Vikram S Dogra, Paul Sidhu, Lorenzo E Derchi, Scrotal and Penile Imaging working group of the European Society of Urogenital Radiology (ESUR-SPIWG) and the Section of Urological Imaging of the European Association of Urology (ESUI)
Department of Radiology, Hospital of Cattinara, University of Trieste, Trieste, Italy., Martini Clinic (Prostate Cancer Center), University of Hamburg, Hamburg, Germany., Department of Urology, Hospital of Cattinara, University of Trieste, Trieste, Italy - ., Polyclinic of Bari, Aldo Moro University, Bari, Italy., Department of Radiology, University of Rochester, Rochester, NY, USA., Department of Radiology, King's College Hospital, London, UK., Section of Emergency Radiology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/36940164