Reliability of colour Doppler ultrasound in the differential diagnosis of acute scrotum

2011 ◽  
Vol 152 (23) ◽  
pp. 909-912 ◽  
Author(s):  
Laura Sándor ◽  
Tímea Gajda ◽  
Vanda Aranyi ◽  
István Csízy ◽  
Tamás Cserni
Keyword(s):  
Differential Diagnosis ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Testicular Torsion ◽  
Color Doppler ◽  
False Negative ◽  
Acute Scrotum ◽  
Colour Doppler ◽  
Colour Doppler Ultrasound ◽  
Operative Notes

Acute scrotum, when testicular torsion is suspected, needs emergency exploration. However, acute scrotum caused by torsion of the Morgagni hydatid and epididymitis can be managed conservatively. Real time colour Doppler ultrasound is becoming a more and more popular tool in the differential diagnosis, however, its reliability is still not widely accepted and exploration is preferred. Material and methods: Case notes of 124 patients treated with acute scrotum during the last 10 years have been reviewed, and the result of physical examination, color Doppler ultrasound, operative notes and clinical outcome were analysed. Results: The final diagnosis was torsion of Morgagni hydatid in 100 cases, furthermore 11 testicular torsion, 8 epididymitis and 10 idiopathic cases were identified. Preoperative colour Doppler ultrasound was done in 45 cases, and exploration was performed in 111 cases. In 38 cases the colour Doppler ultrasound excluded and in 7 cases verified the possibility of testicular torsion. Two false positive and 0 false negative cases were identified. The specificity was 95.0%, sensitivity 100.0%, negative predictive value 100.0%, and positive predictive value 71.4%. Discussion: Colour Doppler ultrasound seems to be a reliable tool in the differential diagnosis of acute scrotum. Its routine use could reduce the number of emergency explorations. Orv. Hetil., 2011, 152, 909–912.

Is Colour Doppler Ultrasound a Sensitive Screening Method in Diagnosing Deep Vein Thrombosis after Hip Surgery ?

1996 ◽  
Vol 75 (02) ◽  
pp. 242-245 ◽  
Author(s):  
Marie Magnusson ◽  
Bengt I Eriksson ◽  
Peter Kãlebo ◽  
Ramon Sivertsson
Keyword(s):  
Deep Vein Thrombosis ◽  
High Risk ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Screening Method ◽  
Colour Doppler ◽  
Vein Thrombosis ◽  
Colour Doppler Ultrasound ◽  
Asymptomatic Patients ◽  
Deep Vein

SummaryPatients undergoing orthopedic surgery are at high risk of developing deep vein thrombosis. One hundred and thirty-eight consecutive patients undergoing total hip replacement or hip fracture surgery were included in this study. They were surveilled with colour Doppler ultrasound (CDU) and bilateral ascending contrast phlebography. The prevalence of proximal and distal DVT in this study was 5.8% and 20.3% respectively.CDU has a satisfactory sensitivity in patients with symptomatic deep vein thrombosis, especially in the proximal region. These results could not be confirmed in the present study of asymptomatic patients. The sensitivity was 62.5% (95% confidence interval: C.I. 24-91%) and the specificity 99.6% (C.I. 98-100%) for proximal DVT; 53.6% (C.I. 34-73%) and 98% (C.I. 96-99%) respectively for distal thrombi. The overall sensitivity was 58.1% (C.I. 39-75%) and the specificity 98% (C.I. 96-99%). The positive predictive value was 83.3% (C.I. 36-99%) and 75% (C.I. 51-91%) for proximal and distal DVT respectively. The negative predictive value was 98.9% (C.I. 98-100%) and 94.9% (C.I. 92-98%) for proximal and distal DVT respectively. The results of this study showed that even with a highly specialised and experienced investigator the sensitivity of CDU was too low to make it suitable for screening purposes in a high risk surgical population.

scholarly journals Diagnostic Accuracy of Doppler Ultrasound Compared to Surgical Exploration in Torsion Testis

2021 ◽  
Vol 10 (35) ◽  
pp. 3035-3039
Author(s):  
Murali Thekeveetil ◽  
Sajitha Krishnadas ◽  
, JayaKoothupalakal Vishwambharan
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Testicular Torsion ◽  
Clinical Findings ◽  
Acute Scrotum ◽  
Care Hospital ◽  
Predictive Values ◽  
Doppler Evaluation

BACKGROUND Twisting of the spermatic cord resulting in ischemia of the testicles known as testicular torsion is a surgical emergency. Delay in diagnosis or surgery results in loss of testicles. Doppler ultrasound of scrotum is used in evaluating acute scrotum to support or rule out a diagnosis of torsion testis. Our study compares Doppler results with findings at exploration to finding out the accuracy of Doppler diagnosis in this scenario. METHODS This was a record based observational cross-sectional study. Out of all cases of acute scrotum presented to a tertiary care hospital over 14 months time, those patients with Doppler evaluation done were identified (n = 52) and their surgical findings were compared to the Doppler findings. Diagnostic accuracy of Doppler in diagnosing torsion testis was measured using sensitivity, specificity, accuracy, and predictive values. RESULTS Out of these 52 cases, 44 (84.6 %) were testicular torsion on exploration while remaining cases were epididymo-orchitis four (7.7 %) and testicular appendage torsion four (7.7 %). Among 44 cases of torsion testis, 31 (70.5 %) patients underwent orchiectomy (70.45 %) and in remaining 13 (29.5 %) orchiopexy was done. Sensitivity of Doppler to diagnose testicular torsion was 86.4 %, specificity was 87.5 % and accuracy was 86.54 %. Positive predictive value (PPV) was 97.4 % and negative predictive value (NPV) was 53.8 %. CONCLUSIONS Doppler ultrasound can be used as an adjunct to clinical findings in acute scrotum. High positive predictive value suggest that all Doppler diagnosed torsion should undergo emergency exploration as it will be correct in 97.5 % cases. If performing a Doppler study delays the definitive management, and if clinical findings are highly suggestive of testicular torsion, treating doctor can proceed to surgery without Doppler evaluation. KEY WORDS Doppler, Torsion Testis, Scrotum

scholarly journals Acute scrotum: differential diagnosis and treatment

2018 ◽  
Vol 97 (3) ◽  
pp. 278-282
Author(s):  
João Arthur Brunhara Alves Barbosa ◽  
Marco Antonio Arap
Keyword(s):  
Blood Flow ◽  
Differential Diagnosis ◽  
Testicular Torsion ◽  
Color Doppler ◽  
Testicular Tumor ◽  
Signs And Symptoms ◽  
Clinical Syndrome ◽  
Acute Scrotum ◽  
Viral Etiology ◽  
Scrotal Pain

Acute scrotum (AS) is a clinical syndrome characterized by scrotal pain of acute onset, often accompanied by scrotal swelling and other local and systemic signs and symptoms. It may be the initial presentation of several diseases including testicular torsion, orchitis, epididymitis, hydatid torsion, strangulated hernia and, less frequently, scrotal hematoma and testicular tumor. In the setting of emergency services, physicians should be extremely careful with the possibility of testicular torsion. This condition consists in the torsion of the spermatic cord, leading to an interruption of the testicular blood flow, with ischemia and ultimately necrosis. It is associated with acute severe pain, nausea, absence of the cremasteric reflex, and a high-riding testis. Physical examination may help diagnosis. However, a color Doppler ultrasound of the scrotum is usually required for a definitive diagnosis. Ultrasound will reveal a reduction or no blood flow to the affected testis; surgical treatment is mandatory and should be performed as early as possible. A differential diagnosis is orchiepididymitis. It may be of viral etiology in early childhood and bacterial after the beginning of sexual activity. The most specific sign associated with this condition is the relief of pain after elevation of the testis, known as Prehn’s sign. Treatment for bacterial cases requires antibiotics, while cases of viral etiology require only symptomatics. Hydatid torsion, including torsion of appendix testicularis and appendix epididymis may mimic testicular torsion but on ultrasound, blood flow is preserved, and a twisted appendix is often seen. Treatment for this condition consists only in symptomatic control. Testicular torsion should be treated as early as possible, since a delay of 6 hours may result in organ loss. Surgery consists of bilateral orchiopexy in case of a viable testicle and orchiectomy of a necrotic organ, always with fixation of the contralateral testicle.

Differential diagnosis of lymph node lesions: a semiquantitative approach with colour Doppler ultrasound.

1998 ◽  
Vol 71 (848) ◽  
pp. 828-833 ◽  
Author(s):  
H J Steinkamp ◽  
M Mueffelmann ◽  
J C Böck ◽  
T Thiel ◽  
P Kenzel ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Lymph Node ◽  
Doppler Ultrasound ◽  
Colour Doppler ◽  
Colour Doppler Ultrasound

scholarly journals Diagnostic accuracy of Color Doppler of cerebral and umbilical pulsatality in diagnosing IUGR, taking birth weight as gold standard.

2020 ◽  
Vol 27 (03) ◽  
pp. 651-659
Author(s):  
Syed Anjum Mehdi ◽  
Hassan Bukhari ◽  
Iqbal Hussain Dogar ◽  
Irfan Shabbir
Keyword(s):  
Birth Weight ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
False Negative ◽  
Colour Doppler ◽  
True Negative ◽  
Colour Doppler Ultrasonography

Objectives: To determine the diagnostic accuracy of colour Doppler of cerebral and umbilical pulsatality in diagnosing IUGR, taking birth weight as gold standard. Study Design: Descriptive, Cross Sectional Study. Setting: Department of Radiology, DHQ Hospital, Faisalabad. Period: 30th May 2016 to 29th November 2016. Material & Methods: Total 129 clinically suspected IUGR, 18 to 40 years of age with singleton pregnancy were included. Patients having Hb< 8.5 g/dl, chromosomal abnormality, chronic infections, severe systemic illness like uncontrolled diabetes mellitus, cardiac disease, renal or hepatic disease were excluded. Colour Doppler Ultrasonography of the cerebral and umbilical artery was performed in every patient and looked for IUGR. Colour Doppler sonography findings were compared with birth weight of baby. Results: Mean age was 30.26 ± 4.67 years. The mean gestational age was 38.60 ± 1.27 weeks. Mean parity was 2.68 ± 0.74. In Colour Doppler Ultrasonography positive patients, 64 were true positive while 09 were false positive. Among, 56 Colour Doppler Ultrasonography negative patients, 07 were false negative while 49 were true negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of colour Doppler of cerebral and umbilical pulsatality in diagnosing IUGR, taking birth weight as gold standard was 90.14%, 84.49%, 87.67%, 87.50% and 87.60% respectively. Conclusion: This study concluded that diagnostic accuracy of colour Doppler of cerebral and umbilical pulsatality in diagnosing IUGR is quite high.

The Role of Doppler Ultrasound, CT Angiography, and Conventional Angiography in Detection of Peripheral Arterial Disease

2021 ◽  
pp. 154431672110303
Author(s):  
Sayan Sarkar ◽  
Shyam Mohan ◽  
Shakthi Parvathy
Keyword(s):  
Computed Tomography ◽  
Peripheral Arterial Disease ◽  
Ct Angiography ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Color Doppler ◽  
Statistical Significance ◽  
Arterial Disease ◽  
P Value ◽  
Peripheral Arterial

The purpose of this study is to analyze how accurate duplex ultrasonography using color Doppler and computed tomography (CT) angiography are in detection of peripheral arterial disease (PAD) in comparison with the Gold Standard of digital subtraction angiography (DSA). This is a single-center prospective, analytical study done on patients with symptoms of PAD referred to the Department of Radiodiagnosis of Medical Trust Hospital (n = 53). All patients were imaged with color Doppler, CT angiography, and DSA. The peak systolic velocity (PSV) ratio was calculated by Doppler ultrasound, and the percentage stenosis for the same vascular segments was calculated using CT angiography and DSA. To test the statistical significance between the results, chi-square test was used. A P value <.05 indicates statistical significance. The PSV ratio for each grade—normal (<1.5), mild (1.5-2.8), moderate (2.9-4.9), and severe (≥5)—and the percentage of stenosis for each grade observed on CT angiography—normal (<20% stenosis), mild (20%-49% stenosis), moderate (50%-74% stenosis), severe (75%-99% stenosis), and total occlusion (100% stenosis)—were found to be highly sensitive and specific with good positive predictive value, negative predictive value, and accuracy level when compared with DSA with narrow confidence intervals for each range. The P value was <.001 for both color Doppler and CT angiography. Computed tomography angiography can be an effective tool as an alternative to DSA for gradation of stenosis if the artifacts resulting from vascular calcification can be avoided. Duplex ultrasonography can be utilized for gradation of stenosis by using the value of PSV ratio and spectral pattern together. However, it can only act as an adjunct to CT angiography because it is incapable of imaging the full length of the arterial segments in 1 frame.

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