Acute testicular torsion: comparison of unenhanced and contrast-enhanced power Doppler US, color Doppler US, and radionuclide imaging.
OBJECTIVE
To compare the usefulness of conventional color Doppler ultrasound (US), unenhanced and contrast material-enhanced power Doppler US, and radionuclide imaging in a model of acute testicular torsion.


METHODS
Twenty rabbits underwent unilateral 360 degree testis torsion and contralateral orchiopexy. Gray-scale, color Doppler, and unenhanced and contrast-enhanced power Doppler US were performed 4-6 hours later. The side of torsion was determined, and intratestis flow was graded. Within 2 hours of US, technetium-99m pertechnetate was intravenously administered, the rabbits were killed, and the testes excised for radionuclide imaging.


RESULTS
Intratestis perfusion was detected in 85% of torsed testes at US and radionuclide imaging. The side of torsion was correctly diagnosed in 25% of cases with radionuclide imaging and in 60% of cases with US. Power Doppler US demonstrated significantly greater intratestis flow in pexed than in torsed testes. Although the numbers of correct diagnosis with the three US modalities were similar, flow grades within torsed and normal testes were significantly different.


CONCLUSIONS
Perfusion to torsed and normal testes was demonstrated equally well with color Doppler US, power Doppler US, and radionuclide imaging. Doppler US better depicted differences in intratesticular flow between torsed and normal testes.
Coley
B D
BD
Department of Radiology, Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Frush
D P
DP
Babcock
D S
DS
O'Hara
S M
SM
Lewis
A G
AG
Gelfand
M J
MJ
Bove
K E
KE
Sheldon
C A
CA
D000208:Acute Disease; D000818:Animals; D003287:Contrast Media; D008297:Male; D011134:Polysaccharides; D011817:Rabbits; D011877:Radionuclide Imaging; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m; D013086:Spermatic Cord Torsion / Q000000981:diagnostic imaging*; D013737:Testis / Q000098:blood supply / Q000473:pathology; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color / Q000379:methods
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D013670:Sodium Pertechnetate Tc 99m