title: Role of contrast enhanced ultrasound in acute scrotal diseases.
abstract: OBJECTIVE
  To evaluate the efficacy of contrast-enhanced ultrasound (CEUS) in patients with acute scrotal pain not defined at ultrasound (US) with colour Doppler .
  
  
  METHODS
  CEUS was carried out in 50 patients with acute scrotal pain or scrotal trauma showing testicular lesion of undefined nature at US. The accuracy of US and CEUS findings versus definitive diagnosis (surgery or follow-up) was calculated.
  
  
  RESULTS
  Twenty-three patients had a final diagnosis of testicular tumour, three abscess, eight focal infarction, seven trauma, three testicular torsion, one haematoma. Five patients were negative. Thirty-five patients were operated (23 testicular tumours, six trauma, three testicular torsion, one abscess, one focal infarction, and one haematoma) and 15 underwent medical treatment or were discharged. US provided a definitive diagnosis in 34/50 as compared to the 48/50 patients diagnosed at CEUS. Sensitivity and specificity were 76% and 45% for US and 96% and 100% for CEUS respectively.
  
  
  CONCLUSIONS
  CEUS was more accurate in the final diagnosis compared to US, potentially reducing the need for further imaging. In particular CEUS can be proposed in emergency in cases where US diagnosis remains inconclusive, namely in infarction, and trauma, when testicular torsion cannot be ruled out, and in identifying testicular mass.
authors.affiliation: Department of Diagnostic Imaging-Emergency Radiology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy. mvalentino@ao.pr.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Valentino
authors.forename: Michele
authors.initials: M
authors.lastname: Bertolotto
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Derchi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bertaccini
authors.forename: Pietro
authors.initials: P
authors.lastname: Pavlica
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Martorana
authors.forename: Libero
authors.initials: L
authors.lastname: Barozzi
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003287:Contrast Media; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D004823:Epididymitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D005832:Genital Diseases, Male / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009920:Orchitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D011446:Prospective Studies; D018570:Risk Assessment; D012611:Scrotum / Q000000981:diagnostic imaging* / Q000473:pathology*; D013086:Spermatic Cord Torsion / Q000175:diagnosis / Q000000981:diagnostic imaging; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media