Добірка наукової літератури з теми "Scrotal and transrectal colour Doppler ultrasound"

Introduction The number of male patients with clinical presentation of infertility, especially secondary infertility after infections, is increasing every day. Contemporary urological standards in defining male infertility include ultrasound examination. Ultrasound examination of the scrotum using color doppler is of great importance. Diagnosis of male infertility Testicular atrophy, microlithiasis and varicocele are the most common causes of male infertility. Microlithiasis and classical testicular microlithiasis are not directly associated with infertility. Gray scale sonography is used in evaluation of the dilatation of the testicular veins, but color Doppler made a real contribution in revealing subclinical varicocele. Transrectal ultrasound is used in a number of pathological conditions of prostate, seminal vesicles and ducts. In cases of obstructive azoospermia it is important to find out the cause, such as focal prostatitis, cysts, ejaculatory ducts obstruction or absence of vas deferens. Conclusion UIltrasound is a noninvasive method easy to perform, which provides information without postexamination consequences such as strictures or obstructions, which are possible after invasive deferentography. Ultrasound guided biopsy, provides a new minimally invasive diagnostic tool in current urology.

Background: Traditionally acute scrotal pain is evaluated by gray scale ultrasound, which dissipated only the morphological changes of the lesion. But pattern of vascularity either normal, increased or absent of affected structure help to definitive diagnosis of the lesion and help to proceed the type of management either medical therapy or surgical treatment.Objectives: To determine the relative importance of color Doppler in the evaluation of acute scrotal pain by ultrasound.Methods: From June 2013 to June 2017 a total 150 patients with acute scrotal pain were selected. A thorough history taking and physical examination were done. Then patient were scanned with gray scale ultrasound followed by color Doppler study. Color Doppler diagnosis is compared with gray scale diagnosis.Results: In gray scale ultrasonography among the 150 cases, 54% were diagnosed as epididymitis, 16.66% were epididymo-orchitis and 16% patient diagnosed as normal. But in combined gray scale and colour Doppler study 58% were diagnosed as epididymitis, 22% were epididymo-orchitis and 6% of patient diagnosed as normal. In gray scale 10% patient were diagnosed as normal but become epididymitis and epididymo-orchitis in colour Doppler. Four percent were diagnosed as epididymitis in gay scale but became epididymo-orchitis in colour Doppler. Four percent patient was diagnosed as epididymitis orchitis but became testicular torsion in Doppler study. Total 14.66% of gray scale diagnosis became another diagnosis in the Doppler study.Conclusion: Combined gray scale and color Doppler study is superior than gray scale ultrasound in differentiating various cause of acute scrotal pain.Bang Med J (Khulna) 2017; 50 : 26-30

Ultrasound (US) is now the accepted modality of choice for imaging the scrotal contents, in particular for evaluation of suspected testicular pathology. There are numerous scrotal pathologies which present with pain, swelling and/or a mass. Testicular lesions vary from the benign to the malignant and also include surgical emergencies and infections. Using 'colour' and applying 'power' Doppler assist in making the diagnosis. However, differentiating between lesions requires a highly skilled US examiner, a sound knowledge of the normal US anatomy and knowledge of the US appearance of numerous conditions. This article reviews the US appearances of many common scrotal pathologies.

The objectives of this study were to: (1) establish the causes of scrotal swelling in the hospital catchment population; (2) define the role of high frequency ultrasound examination in the management of scrotal swelling. A retrospective study of 582 patients who had high frequency ultrasound examination was carried out. Those requiring more information on perfusion had colour doppler examination. Forty-four per cent of examinations were performed for scrotal swelling. The cause of the scrotal swelling was mainly extratesticular (75% of all scrotal swellings), hydrocele being the commonest. Of the intratesticular causes, infection (50.8%) and tumour (20.6%) were the commonest. In conclusion ultrasound examination distinguishes extratesticular (almost always benign) from intratesticular (potentially malignant) causes of scrotal swelling. Infection, trauma and torsion mimic the ultrasound appearance of tumour as do rare benign entities.

Multiparametric ultrasound (MPUS), combining conventional techniques (greyscale and colour Doppler ultrasound), ultrasound strain elastography, and contrast-enhanced ultrasound (CEUS), has been successfully used in the assessment of adult scrotal pathology. Contrast-enhanced ultrasound can confidently establish testicular tissue vascularity even in the small-volume paediatric testis. Elastography provides further assessment of tissue stiffness, potentially adding useful diagnostic information. In children, ultrasonography is particularly advantageous, being safe, radiation-free and negating the need for sedation or general anaesthesia during the imaging evaluation. In this review article, we aim to familiarise readers with the MPUS scanning protocol used for paediatric scrotal examination and provide an overview of scrotal MPUS features, with particular focus to clinical indications where MPUS may be advantageous over conventional ultrasonography.

Introduction: Testicular torsion is a time sensitive condition for which there can be significant delays to surgery or transfer to definitive care while trying to obtain an ultrasound to confirm the diagnosis. This study determines the test characteristics for each individual sonographic sign of testicular torsion associated with the patient requiring surgical intervention. Methods: A retrospective health records review of adult patients with acute, non-traumatic scrotal pain or swelling (defined as under 24 hours since onset) presenting to one of two Canadian academic tertiary care emergency departments between November 2009 and March 2013 was performed. A single data abstractor completed a case report form for each patient including demographics, individual ultrasound findings, final diagnosis, and need for surgical intervention. The sensitivity and specificity of each ultrasonographic sign (including testicular heterogeneity, decreased colour doppler, and decreased pulsed wave doppler) at predicting surgical intervention during the same hospital visit was calculated along with 95% confidence intervals. Results: During the study period there were a total of 876 emergency department visits for scrotal pain, of which 198 patients met our inclusion criteria. The included patients had a mean age of 36.2 years. Decreased blood flow to the painful testicle on colour doppler showed the best overall test characteristics with a sensitivity of 82.4% (95% CI 55.8%-95.3%) and specificity of 100% (95% CI 96.3%-100%) for predicting a need for surgical intervention for testicular torsion. Other ultrasound findings for testicular torsion included a heterogeneous appearance of the painful testicle (sensitivity 47.1% [95% CI 23.9%-71.5%], specificity 77.4% [95% CI 68.9%-84.2%]), and decreased arterial or venous flow on pulsed wave doppler (sensitivity 76.5% [95% CI 49.8%-92.1%], specificity 100% [95% CI 96.3%-100%]). Conclusion: Decreased blood flow to the painful testicle on colour doppler showed excellent specificity and can rapidly “rule-in” a need for surgical intervention for testicular torsion. Given that colour doppler is relatively easy to learn and perform, future studies should assess the use of colour doppler using point of care ultrasound to expedite surgical consultation.

The advent of colour Doppler ultrasound has allowed evaluation of blood flow to bodily tissues. This novel technology is being tested as a tool to improve efficiency in a variety of livestock reproduction programs. The objective of the present study was to evaluate the relationship between blood flow to the ovarian corpus luteum (CL), imaged via colour Doppler ultrasound, and pregnancy rate in crossbred dairy recipients for embryo transfer (ET). Oestrous cycles of Bos indicus×Bos taurus dairy heifers (n=90, 16-24 months of age) were synchronized for embryo transfer on Days 7-8. Immediately before ET, heifers were palpated for the presence of ovarian CL and CL papillae. Presence of CL, CL papillae, and CL lacunae were confirmed via transrectal B-mode ultrasound (Ibex EVO I, E. I. Medical Imaging). Transrectal colour Doppler ultrasound (Ibex EVO I, E. I. Medical Imaging) was used to evaluate blood flow to the CL. Invitro-produced (IVP) blastocysts (qualities I and II) were transferred to the uterine horn ipsilateral to the CL. All palpation, imaging, and embryo transfer was performed by a single technician. Pregnancy was determined via transrectal ultrasound 24-32 days post-embryo transfer (31-39 days of embryo age). Blood flow to the CL was split into three categories: high, median, and low. Presence or absence of two additional CL structures, CL papillae and lacunae, were recorded. Fisher's exact test was used to evaluate data. Statistical differences were considered significant at P<0.05. The overall pregnancy rate was determined to be 40%, 36 out of 90. Pregnancy rates were similar in high (33.9%, 20 of 59), median (59.09%, 13 of 22), and low (33.33%, 3 of 9) blood flow categories. Consistent with previous studies, absence of CL papillae and presence of CL lacunae at the time of ET did not affect pregnancy rate. Doppler blood flow, papillae, and lacunae were also evaluated together in each possible combination. Only one outlier was present; all other differences were not significant. The highest pregnancy rate (66.67%, 10 of 15) was observed in recipients with CLs with median Doppler blood flow, a palpable CL papillae, and no CL lacunae. A larger sample size is required to determine the accuracy of this measurement. In conclusion, recipients with high to low CL blood flow are suitable for IVP embryo transfer programs. Alone, colour Doppler imaging of the CL does not predict pregnancy rate.

AIM OF THE THESIS Since Metabolic Syndrome (MetS) is essentially based on increased adiposity and it is associated with male hypogonadism, erectile dysfunction, psychological disturbances, and BPH/LUTS, and all these factors might, in different ways, affect reproductive capacity, we investigated their possible correlations with MetS. Hence, we performed two studies. In the first study (study 1) we evaluated possible associations between MetS, semen and hormonal parameters, as well as clinical characteristics, including sexual, ultrasound and psychological characteristics, in a cohort of men with couple infertility. In the second study (study 2), we systematically investigated the possible associations between MetS and prostate-related symptoms and signs in a cohort of young men in infertile unions and tried to establish whether these associations correlate with fertility. Study 1 conclusions We report that an increasing number of MetS factors are dose-dependently associated with relevant organic (poor sperm quality, hypogonadism, ED) and psychological (depression, somatization) features that might affect reproductive outcomes of men seeking medical care for couple infertility. This might tailor ad hoc therapeutic intervention. Behavioural interventions targeting lifestyle factors, such as dietary practice and physical activity, might ameliorate not only metabolic and psychological parameters but also male infertility, as has been demonstrated for female infertility. Study 2 conclusions This study demonstrates that in a cohort of men with infertility, a component-dependent, stepwise association was observed between an increase in the number of MetS components and the total and transitional zone prostate enlargement and prostate related-inflammatory signs but not symptoms or current infection of the male genital tract, which suggests a sub-clinical inflammation of the prostate. Relative prostate overgrowth may also correlate with MetS-related hyperinsulinaemic state. In addition, MetS but not MetS’s related prostate CDU abnormalities was associated with poor sperm morphology. FINAL CONCLUSIONS In men with couple infertility, MetS is associated with hypogonadism, poor sperm morphology, testis ultrasound inhomogeneity, erectile dysfunction, somatization and depression. In addition, MetS is positively associated with prostate enlargement, biochemical (seminal interleukin 8) and ultrasound-derived signs of prostate inflammation but not with prostate-related symptoms, which suggests that MetS is a trigger for a subclinical, early-onset form of benign prostatic hyperplasia. Recognizing MetS could help patients to improve not only fertility but also sexual and overall health.