Role of High-Resolution Sonography and Doppler in Evaluation of Acute Scrotal Disease

Background: Acute scrotum possesses a difficult diagnostic challenge because of the non- specific nature of symptoms and difficulty in adequately examining the tender, swollen scrotum. It is a cross sectional study, a diagnostic test evaluation to assess the accuracy of doppler ultrasound in the diagnosis of acute scrotal disease and identify and classify causes of acute scrotum based on the sonographic appearance and doppler evaluation. Methods: This is a cross sectional study carried out in 90 patients presented with acute scrotum in Department of Radiodiagnosis Government Medical College Thrissur, over one year starting from December 2020. The patients were evaluated with high resolution ultrasonography and Doppler ultrasound. Ultrasound diagnosis is then compared with final diagnosis arrived after conservative management or postoperative and histopathological findings. Results are analysed, and, with the final data sensitivity, specificity, positive predictive value and negative predictive value are calculated. Results: Color Doppler ultrasound was found to be 100% sensitive and 95% specific for the diagnosis of testicular torsion in our study with positive predictive value of 88.4% and negative predictive value of 100%. Color Doppler ultrasound was found to be 96.61% sensitive and 96.78% specific for the diagnosis of testicular/ epididymal / peri-testicular inflammation with positive predictive value of 98.2% and negative predictive value of 93.75%. Conclusion: Grey-scale changes are nonspecific and Doppler ultrasound clinches the diagnosis when evaluating the differential diagnosis of acute scrotum. Power Doppler sonography, because of its better visualization of low velocity flow, increases the diagnostic accuracy by better characterization of the testicular and peri-testicular perfusion.http://impactfactor.org/PDF/IJTPR/12/IJTPR,Vol12,Issue12,Article12.pd