Dataset Information

Ultrasound characteristics of extravaginal testicular torsion at different stages of disease progression.

ABSTRACT:

Background

Extravaginal testicular torsion has profound clinical implications in neonates, but its ultrasound characteristics may vary at different disease stages. The purpose of this study was to identify the ultrasound characteristics of neonatal extravaginal testicular torsion and their diagnostic value at different disease stages.

Methods

A retrospective analysis of the clinical and ultrasound examination data of 20 infants aged 1-75 days with surgically and pathologically confirmed unilateral extravaginal testicular torsion (10 right, 10 left) was conducted. The infants were divided into three stages based on the ultrasound characteristics: double-ring effusion, calcification of the tunica vaginalis, and testicular atrophy.

Results

In the double-ring effusion stage, the affected testicles were enlarged with axial abnormalities, with the parenchymal testicular blood flow signal significantly reduced or absent. Twisted paratesticular masses and a "double-ring effusion sign" were visible. In the tunica vaginalis calcification stage, the affected testicles were slightly smaller, with axial abnormalities, absent blood flow signals in the testicular parenchyma, and strong echogenicity of the tunica vaginalis. In the testicular atrophy stage, the affected testicles were markedly smaller, with enhanced echogenicity in the tunica vaginalis and parenchyma, and absent blood flow signal in the testicular parenchyma. The volumes of the affected testicles gradually decreased from the stage of double-ring effusion to that of tunica vaginalis calcification, and then to testicular atrophy (P<0.05).

Conclusions

Neonatal extravaginal testicular torsion at different disease stages has distinct ultrasound features, and color doppler ultrasound plays an important role in the diagnosis and treatment of extravaginal testicular torsion.

SUBMITTER: Ban Y

PROVIDER: S-EPMC11320493 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

Ultrasound characteristics of extravaginal testicular torsion at different stages of disease progression.

Ban Yongguang Y Lan Di D Wang Shanshan S Liu Wei W Fu Xiaoqing X Hou Li L Guo Lingfei L Teng Jianbo J Luan Qinhua Q

Quantitative imaging in medicine and surgery 20240716 8

<h4>Background</h4>Extravaginal testicular torsion has profound clinical implications in neonates, but its ultrasound characteristics may vary at different disease stages. The purpose of this study was to identify the ultrasound characteristics of neonatal extravaginal testicular torsion and their diagnostic value at different disease stages.<h4>Methods</h4>A retrospective analysis of the clinical and ultrasound examination data of 20 infants aged 1-75 days with surgically and pathologically con ...[more]

PMID: 39144007

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Project description:BackgroundCryptorchidism increases the risk of testicular torsion, a condition requiring urgent intervention. However, the atypical presentation in these cases makes diagnosis challenging, necessitating improved clinical awareness and management strategies. This study aims to analyze the clinical characteristics, diagnostic methods, and treatment outcomes of testicular torsion in children with cryptorchidism. The goal is to enhance the understanding of this rare condition and provide valuable insights into its diagnosis and management, based on clinical and surgical findings.MethodsA retrospective analysis was conducted on the clinical data of 21 children with cryptorchidism who experienced testicular torsion and were treated at Anhui Provincial Children's Hospital from January 2015 to June 2024. Among the 21 patients, five had bilateral cryptorchidism, all of which involved unilateral testicular torsion, with 16 cases on the left side and five on the right side. The median age of the patients was 48 months [interquartile range (IQR): 8.5-117.5 months]. The median onset time, defined as the time interval between the onset of symptoms and surgical intervention, was 24 hours (IQR: 12-72 hours).ResultsAll patients underwent surgical exploration. The average surgery time was 60.9 [standard deviation (SD): 25.1] minutes, with an average blood loss of 4.5 (SD: 2.3) mL. The median torsion angle was 540° (IQR: 270°-720°). Intraoperatively, 18 testes were found to have irreversible necrosis and were removed, while three were successfully detorsed and preserved with good blood supply. Postoperative follow-up for an average of 50.4 (SD: 18.3) months showed no atrophy in the surviving testes, and the contralateral fixed testes developed well without recurrent torsion.ConclusionsTesticular torsion in children with cryptorchidism is rare and often presents with subtle symptoms. Early diagnosis and treatment are crucial. Ultrasound plays a significant role in the diagnosis of testicular torsion in cryptorchidism. The degree of torsion and the time of onset are critical factors for improving testicular survival rates. It is recommended that surgical intervention be performed early in cryptorchid patients older than six months to reduce the risk of testicular torsion.

Project description:OBJECTIVE:To assess the colour Doppler and ultrasound features of testicular Leydig cell tumours (LCTs) in a population of 38 surgically proven lesions. METHODS:From August 2008 to March 2015, we retrospectively included 38 surgically proven LCTs in 36 patients. Clinical data, scrotal colour Doppler, B-mode ultrasound and videos images were reviewed for each patient. The volume, echotexture of the testis, size, shape, echogenicity and the vascularization pattern of the lesion were evaluated. The tumour margins were categorized as either smooth or lobulated. The vascularization was classified as intense, moderate or without any hypervascularization. We defined the vascularization pattern groups as central, peripheral and mixed (the latter meaning both central and peripheral). RESULTS:26 patients were referred for infertility [5 patients were subsequently diagnosed with Klinefelter syndrome (KS) and 5 patients with cryptorchidism]. 28 patients underwent testis-sparing surgery, while 8 patients underwent a radical orchiectomy. The LCTs were mostly infracentimetric (68.4%), with a median size of 7.0?mm (ranging from 4.0 to 11?mm). 50% of the lesions had lobulated margins, and these were significantly larger than the smooth lesions (p?<?0.05). The content of the lesions was markedly homogeneous and hypoechoic. All lesions had sharp demarcations from the adjacent pulp. 36/38 lesions exhibited moderate-to-intense hypervascularization, with a mixed intrinsic and peripheral rim pattern. Larger lesions were more hypervascularized (p?<?0.05). LCTs in patients with KS had atypical features. CONCLUSION:Typical sporadic LCTs appeared as isolated hypoechoic, infracentimetric masses, with a clear demarcation from the adjacent pulp. They presented intrinsic and peripheral rim hypervascularization. ADVANCES IN KNOWLEDGE:By undertaking the largest imaging series of LCT to date (to our knowledge), we reassessed the typical sonographical aspects of LCTs, so as to provide guidance in regard to opting for testis-sparing surgery and for follow-up. LCTs present both intrinsic and rim vascularization detectable by colour Doppler ultrasound. Intrinsic vascularization and lobulated margins are common findings in testicular LCTs.

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Dataset Information

Ultrasound characteristics of extravaginal testicular torsion at different stages of disease progression.

Background

Methods

Results

Conclusions

Publications

Ultrasound characteristics of extravaginal testicular torsion at different stages of disease progression.

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