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Gray-Scale and Color Doppler Sonography of Scrotal Disorders in Children: An Update¹

¹ From the Departments of Pediatric Radiology (C.A., G.E., M.F., J.P., J.L.), Pathology (N.T.), and Pediatric Surgery (C.P.), Vall d’Hebron Children’s Hospital, Ps Vall d’Hebron 119–129, 08035 Barcelona, Spain. Recipient of a Certificate of Merit award for an education exhibit at the 2003 RSNA Annual Meeting. Received May 18, 2004; revision requested October 13 and received January 13, 2005; accepted January 17. All authors have no financial relationships to disclose. Address correspondence to G.E. (e-mail: genriquez{at}vhebron.net).

Ultrasonography (US) is well suited to the study of pathologic conditions of the scrotum in children. US provides excellent anatomic detail; when color Doppler and power Doppler imaging are added, testicular perfusion can be assessed. Gray-scale, color Doppler, and power Doppler US were used to study a spectrum of scrotal disorders in 750 boys aged 1 day to 17 years. The entities studied included processus vaginalis–related disorders (cryptorchidism, inguinal-scrotal hernia, and hydrocele); varicocele; acute scrotum (epididymo-orchitis, torsion of the testicular appendages, and testicular torsion); scrotal tumors; testicular microlithiasis; scrotal trauma; and systemic diseases with scrotal involvement. When combined with the results of clinical and physical examination, the information obtained with US is sufficient to enable diagnosis in most cases of scrotal disease. Moreover, color Doppler imaging is essential for differentiation between processes such as epididymo-orchitis or torsion of the testicular appendages and testicular torsion, which have similar clinical manifestations (pain, swelling, and redness) but are managed differently.

© RSNA, 2005

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