Color Doppler sonography and scintigraphy of the testis: a prospective, comparative analysis in children with acute scrotal pain.
OBJECTIVE
To compare testicular color Doppler sonography with testicular scintigraphy in differentiating between surgical and nonsurgical conditions of the pediatric testis, and to evaluate the role of testicular color Doppler sonography in the pediatric population.


METHODS
Forty-six children (age range, 1 day to 18 years; median age, 11 years) with acute scrotal pain were evaluated with both scintigraphy and color Doppler sonography by two separate groups of radiologists who had no knowledge of the results of the other modality. The final radiologic diagnosis was classified as a surgical condition, nonsurgical condition, or indeterminate and was compared with the patient's surgical diagnosis or clinical diagnosis, which was established by response to treatment and follow-up.


RESULTS
Sonography correctly diagnosed 11 of 14 surgical conditions and 31 of 32 nonsurgical conditions. There was one indeterminate sonogram. There were no false-positive examinations, and there were three false-negative examinations (sensitivity = 78.6% [95% CI, 66.7-90.5%], specificity = 96.9% [95% CI, 94.3-99.5%], accuracy = 91.3%). Color flow was demonstrated in the asymptomatic testis in 34 of 44 boys. Scintigraphy correctly diagnosed 11 of 14 surgical conditions and 29 of 32 nonsurgical conditions. There were two indeterminate scintigrams. There were two false-positive examinations and two false-negative examinations (sensitivity = 78.6% [95% CI, 66.7%-90.5%], specificity = 90.6% [95%CI, 82.2%-99.0%], accuracy = 87.0%).


CONCLUSIONS
Color Doppler sonography and scintigraphy show similar sensitivity for the diagnosis of testicular torsion. A small number of false-negative cases can occur with either modality. The two studies may provide complementary information in indeterminate cases.
Nussbaum Blask
Anna R
AR
Department of Radiology, The Children's National Medical Center, George Washington University, Washington, DC 20010, USA. ablask@cnmc.org
Bulas
Dorothy
D
Shalaby-Rana
Eglal
E
Rushton
Gil
G
Shao
Cheng
C
Majd
Massoud
M
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010146:Pain / Q000175:diagnosis*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012611:Scrotum / Q000098:blood supply; D012680:Sensitivity and Specificity; D013086:Spermatic Cord Torsion / Q000175:diagnosis*; D013733:Testicular Diseases / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color