High Resolution Ultrasound and Colour Doppler in the Diagnosis and Distinction of Various Scrotal Diseases.

Abstract

Aims: To classify (etiologically) and to evaluate various scrotal pathologies using
ultrasonography and describe the role of High resolution ultrasound and colour doppler in their
diagnosis and differentiation.
Methods: A prospective study was conducted in the Department of Radiology VIMS
Pawapuri, Nalanda, Bihar, India, for 1 year. The 100 patients with clinical features of scrotal
diseases were include in this study. All the patients included in the study underwent scrotal
ultrasonography using 7.0- 12.0 MHZ high frequency linear array transducer coupled with
Colour Doppler in Esaote My Lab 40 and Phillips affinti 70G equipments.
Results: The patients most commonly involved were those belonging to the age group of 30 to
40 years (38%). The least number of patients belonged to the age group of 0-10 years (4%).
On USG, the total number of lesions detected were 120. The most common cause of scrotal
pathologies was hydrocele (n=31, 25.83%) followed by epididymal cyst (n= 20, 16.67%),
epididymo-orchitis (n =16, 13.33%), epididymitis (n = 9; 7.5%), funiculitis (n=8, 6.67%),
varicocele (n = 7, 5.83%), pyocele (n= 6, 5%), testicular torsion (n=5, 4.17%), testicular
abscess (n = 5, 4.17%), inguino-scrotal hernia (n = 4, 3.33%), testicular microlithiasis (n= 3,
2.5%), testicular tumour (n=3, 2.5%) and tubercular epididymo-orchitis (n=3, 2.5%) . The
number of scrotal lesions seen on the left side were 45(37.5%), on the right side were 35
(29.17%) and in bilateral locations were 20(16.67%). Associated symptoms included swelling,
pain, fever and infertility. Almost all the scrotal pathologies were associated with scrotal
swelling (n=97, 97%) except in 3 cases. Epididymal cysts were seen in 20 patients, Acute
epididymo-orchitis(n=16) was most commonly seen on the left side. Hydrocele (n=31) was the
most common scrotal pathology detected in this study.
Conclusion: High frequency ultrasonography with Color Doppler study serves as an excellent
diagnostic imaging modality in the evaluation of scrotal diseases. It is the investigation of choice since it is highly sensitive, easy to perform, widely available, repeatable and involves
no risk of ionizing radiation.