Journal of Ultrasound in Medicine, Vol 12, Issue 6 317-322, Copyright © 1993 by American Institute of Ultrasound in Medicine
Duplex Doppler sonographic examinations of the testis in prepubertal boys
S. Jequier, H. Patriquin, D. Filiatrault, L. Garel, A. Grignon, J. C. Jequier and T. Petitjeanroget
Department of Radiology, Ste-Justine Hospital, University of Montreal, Quebec, Canada.
This retrospective study of 143 pediatric patients with unilateral acute
scrotal disease was done to assess the value of duplex Doppler sonographic
examination prior to puberty (110 patients) in comparison to a pubertal
group (33 patients) in a pediatric hospital, where the examinations are
done by staff radiologists and radiology residents of varying degrees of
expertise and experience with Doppler technique. All patients seen during
an 18 month period were included. The unaffected side was examined in most
patients and served as control. The normal Doppler shift in the center of
the prepubertal testis was found to be 0.2 to 0.5 kHz, when using a 5 MHz
duplex Doppler probe. With puberty, the Doppler shift increased to 0.5 to 1
kHz. Of 18 patients (10 prepubertal) with testicular torsion, five (three
prepubertal) had false-positive Doppler shift. In four of these five cases,
faulty placement of the Doppler sample volume cursor was probably the
cause. Using a multi-way frequency analysis, puberty was found to have no
significant influence on results of Doppler signal (chi square = 0.1346; P
= 0.7137). Duplex Doppler sonographic examination is as useful to rule out
testicular torsion in prepubertal boys as it is after puberty. Meticulous
technique is essential. The opposite side should be examined first and
serves as control for the affected one. Results showing no flow in the
center of the diseased testis with positive flow in the unaffected one
should lead to further clinical action (scintigraphy or surgery).
