Color Doppler sonography of normal and torsed testicular appendages in children.
OBJECTIVE
The purpose of our study was to determine the size and appearance of normal and torsed testicular appendages on color Doppler sonography.


METHODS
Thirty-three patients with acute scrotal pain underwent gray-scale and color Doppler sonography and subsequent surgery. Twenty-two patients had torsion of the appendix testis, six had epididymitis, three had torsion of the testis, and two had torsion of the appendix epididymidis. The testicular appendages of 30 patients and the testes of three were excised and sent to the laboratory for histopathologic examination.


RESULTS
A testicular appendage was identified on color Doppler sonography in 23 patients (21 patients with torsed appendages and two patients with epididymitis). The torsed appendixes testis measured from 4.1 to 16.3 mm, and the normal appendixes in the two patients with epididymitis measured 4.1 and 5.6 mm. With the visualization of an appendix larger than 5.6 mm as the sonographic diagnostic criterion for torsion of a testicular appendage, sensitivity was 68.2% (95% confidence interval (CI), 45.1-85.3%), and specificity was 100% (CI, 74.7-100%).


CONCLUSIONS
The identification of a testicular appendage larger than 5.6 mm is suggestive of torsion. Therefore, depending on the patients' clinical conditions, these cases can be treated conservatively when an appendage larger than 5.6 mm is identified.
Baldisserotto
Matteo
M
Hospital da Criança Conceição, Ministério da Saúde, Brazil, Eca de Queiroz 384, Apt. 502, Porto Alegre, RS, Brazil, 90.670-020. matteob@terra.com.br
de Souza
João Carlos Ketzer
JC
Pertence
Ana Paula
AP
Dora
Marcelo Dourado
MD
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004823:Epididymitis / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D012680:Sensitivity and Specificity; D013733:Testicular Diseases / Q000000981:diagnostic imaging*; D014102:Torsion Abnormality; D018615:Ultrasonography, Doppler, Color