Journal of Ultrasound in Medicine, Vol 16, Issue 1 23-27, Copyright © 1997 by American Institute of Ultrasound in Medicine
Sonographic prediction of viability in testicular torsion: preliminary observations
W. D. Middleton, M. A. Middleton, M. Dierks, D. Keetch and S. Dierks
Mallinckrodt Institute of Radiology, St. Louis, MO 63110, USA.
This study was performed to determine if sonography can assist in
predicting testicular viability in the setting of testicular torsion.
Sixteen patients with sonographically diagnosed and surgically proved
testicular torsion were studied. The preoperative sonograms were reviewed
retrospectively to determine testicular echogenicity and homogeneity,
testicular size and vascularity, scrotal skin thickness and vascularity,
and the presence or absence of a hydrocele. These findings were correlated
with the viability of the testis at surgery. All nine patients with normal
homogeneous testicular echogenicity had viable testes at surgery. All seven
patients with hypoechoic or inhomogeneous testes had nonviable testes at
surgery and pathologic evidence of necrosis. The other findings were less
helpful in predicting viability. In the setting of testicular torsion,
normal testicular echogenicity is a strong predictor of viability.
Immediate surgical detorsion in these patients carries a very high
likelihood of salvaging the affected testis.
