Advertisement

Scrotal Scintigraphy

  • G. A. Taylor
  • L. P. Connolly
  • S. T. Treves

Abstract

Scrotal scintigraphy has improved our ability to evaluate children with acute testicular pain. Before the introduction of this technique in 1973 by Nadel et al.26 the differentiation between testicular torsion and epididymitis on purely clinical grounds was frequently difficult.16 It often required (and frequently still does) scrotal exploration for definitive diagnosis. Although surgical exploration is a relatively benign and reliable method of diagnosis, scrotal scintigraphy offers a noninvasive, highly reliable means of differentiating nonsurgical inflammatory processes from ischemic conditions that require urgent surgery. A good history and careful clinical examination of the patient are prerequisites for appropriate use of scrotal scintigraphy. Indiscriminate use of scrotal scintigraphy for routine screening of the acute scrotum can result in unnecessary delays and unjustifiable expense.10

Keywords

Tracer Uptake Spermatic Cord Radionuclide Angiography Testicular Torsion Testicular Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Abu Sleiman R, Ho JE, Gregory JG. Scrotal scanning: present value and limits of interpretation. Urology 1973;13:326–330CrossRefGoogle Scholar
  2. 2.
    Amar AD, Kamla C. Epididymitis in prepubertal boys: presenting manifestation of vesicoureteral reflux. JAMA 1969;207:2397–2400PubMedCrossRefGoogle Scholar
  3. 3.
    Atkinson GO, Patricj LE, Ball TL, et al. The normal and abnormal scrotum in children: evaluation with color Doppler sonography. AJR 1992;158:613–617PubMedCrossRefGoogle Scholar
  4. 4.
    Boedecker RA, Glicklich M, Sty JR. Rim sign in endodermal sinus tumor. Clin Nucl Med 1979;4: 130–131PubMedCrossRefGoogle Scholar
  5. 5.
    Boedecker RA, Sty JR, Jona FJ. Testicular scanning as a diagnostic aid in evaluating scrotal pain. J Pediatr 1979;94:760–762PubMedCrossRefGoogle Scholar
  6. 6.
    Doolittle KH, Smith JP, Saylor ML. Epididymitis in the prepubertal boy. J Urol 1966;96:364–366PubMedGoogle Scholar
  7. 7.
    Dunn EKI, Macchia RJ, Solomon NA. Scintigraphic pattern in missed testicular torsion. Radiology 1981;139:175–180PubMedGoogle Scholar
  8. 8.
    Dymus L, Mishkin F. Radionuclide imaging in epi-didymo-orchitis. JUrol 1974; 112:387–389Google Scholar
  9. 9.
    Falkowski WS, Firlit CF. Testicular torsion: the role of radioisotope scanning. J Urol 1980;124:886–888PubMedGoogle Scholar
  10. 10.
    Fenner MN, Roszhart DA, Texter JH. Testicular scanning: evaluating the acute scrotum in the clinical setting. Urology 1991;38:237–241PubMedCrossRefGoogle Scholar
  11. 11.
    Gierup J, von Hedenberg C, Osterman A. Acute nonspecific epididymitis in boys. Scand J Urol Nephrol 1975;9:5–7PubMedCrossRefGoogle Scholar
  12. 12.
    Gislason T, Noronha R, Gregory J. Acute epididymitis in boys: a 5-year retrospective study. J Urol 1980;124:533–534PubMedGoogle Scholar
  13. 13.
    Gray H. Anatomy of the Human Body. Philadelphia: Lea & Febiger, 1973Google Scholar
  14. 14.
    Gray SW, Skandalakis J. The ovary and testis. In: Embryology for Surgeons. The Embryological Basis for the Treatment of Congenital Defects. Philadelphia: Saunders, 1973Google Scholar
  15. 15.
    Haahr J, Sparrevbhn S. Epididymitis in children [abstract]. Acta Paediatr Scand 1970;60:248Google Scholar
  16. 16.
    Hahn LC, Nadel NS, Gitter MH, Vernon AR. Testicular scanning: a new modality for the preoperative diagnosis of testicular torsion. J Urol 1975; 113:60–62PubMedGoogle Scholar
  17. 17.
    Harrison JH, Nickel WR, Plumb RT, et al. Other infections and inflammations of the external genitalia. In: Campbell’s Urology. Philadelphia: Saunders, 1978Google Scholar
  18. 18.
    Holder LE, Martire JR, Holmes ER. Testicular radionuclide angiography and static imaging: anatomy, scintigraphic interpretation and clinical indications. Radiology 1977;125:739–752PubMedGoogle Scholar
  19. 19.
    Kaplan GW, King LR. Acute scrotal swelling in children. JUrol 1970;104:219–223Google Scholar
  20. 20.
    Kogan SJ, Lutfker LG, Perez L. The value of the negative radionuclide scrotal scan in the management of the acute inflamed scrotum in children. J Urol 1979;122:223–225PubMedGoogle Scholar
  21. 21.
    Mevorach RA, Lemer RM, Greenspan BS, et al. Color Doppler ultrasound compared to radionuclide scanning of spermatic cord torsion in a canine model. JUrol 1992;145:428–433Google Scholar
  22. 22.
    Midleton WD, Melson GL. Testicular ischemia: color Doppler sonographic findings in five patients. AJR 1989;152:1237–1239CrossRefGoogle Scholar
  23. 23.
    Mishkin FS. Differential diagnostic features of the radionuclide scrotal image. AJR 1977;128:127–129PubMedCrossRefGoogle Scholar
  24. 24.
    Moharib NH, Krahn HP. Acute scrotum in children with emphasis on torsion of the spermatic cord. J Urol 1970;104:601–603PubMedGoogle Scholar
  25. 25.
    Muschat M. The pathological anatomy of testicular torsion. Surg Gynecol Obstet 1932;54:758–763Google Scholar
  26. 26.
    Nadel NS, Gitter MH, Hahn LC. Preoperative diagnosis of testicular torsion. Urology 1973;1:478–479PubMedCrossRefGoogle Scholar
  27. 27.
    Parker RM, Robison JR. Anatomy and diagnosis of torsion of the testicle. J Urol;1971 106:243–247PubMedGoogle Scholar
  28. 28.
    Riley TW, Mosbaugh PG, Coles JL, et al. Use of radioisotope scan in evaluation of intrascrotal lesions. J Urol 1976; 116:472–475PubMedGoogle Scholar
  29. 29.
    Skoglund RW, McRoberts JW, Ragde H. Torsion of testicular appendages: presentation of 43 new cases and a collective review. JUrol 1970; 104:598–600Google Scholar
  30. 30.
    Smith GI. Cellular changes from graded testicular ischemia. JUrol 1955;73:355–362Google Scholar
  31. 31.
    Smith SP, King LR. Torsion of the testis: techniques of assessment. Urol Clin North Am 1979;6:429–443PubMedGoogle Scholar
  32. 32.
    Stage KH, Schoenvogel R, Lewis S. Testicular scanning: clinical experience with 72 patients. J Urol 1981;125:334–337PubMedGoogle Scholar
  33. 33.
    Sty JR. Starshak RJ, Miller JH. Appleton-Century-Crofts, Norwich, CT: In Sty JR (ed): Pediatric Nuclear Medicine. 1983Google Scholar
  34. 34.
    Thomas WE, Williamson RC. Diagnosis and outcome of testicular torsion. Br J Surg 1983; 70:213–216PubMedCrossRefGoogle Scholar
  35. 35.
    Valvo JR, Caldamone AA, O’Mara R, Rabinowitz R. Nuclear imaging in the pediatric acute scrotum. Am J Dis Child 1982;136:831–835PubMedGoogle Scholar
  36. 36.
    Vieras F, Kuhn CR. Nonspecificity of the “rim sign” in the scintigraphic diagnosis of missed testicular torsion. Radiology 1983;146:519–522PubMedGoogle Scholar
  37. 37.
    Vordermark JS, Buck AS, Brown SR, Tuttle WK. The testicular scan: use in diagnosis and management of acute epididymitis. JAMA 1981;245:2512–2514PubMedCrossRefGoogle Scholar
  38. 38.
    Wasnick RJ, Pobutsky KR, Macchia RJ. Testicular torsion and usefulness of radionuclide scanning. Urology 1980;15:318–320PubMedCrossRefGoogle Scholar
  39. 39.
    Williams CB, Livak AS, McRoberts JW. Epididymitis in infancy. J Urol 1979; 121:125–126PubMedGoogle Scholar
  40. 40.
    Williamson RC. Torsion of the testis and allied conditions. Br J Surg 1976;63:465–476PubMedCrossRefGoogle Scholar
  41. 41.
    Wright JE. Torsion of the testis. Br J Surg 1977;64:274PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • G. A. Taylor
  • L. P. Connolly
  • S. T. Treves

There are no affiliations available

Personalised recommendations