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1

Stojanovic, Sanja, Mira Govorcin, Dusan Hadnadjev, Goran Marusic, Slavica Senicar, and Olivera Nikolic. "The value of ultrasound in diagnosis of male infertility." Medical review 57, no. 11-12 (2004): 551–55. http://dx.doi.org/10.2298/mpns0412551s.

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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.
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2

Salahuddin, Gazi, SM Zulker Nayeem, Syed Mozammel Hossain, Sadika Parvin, and Md Monoar Hossain. "Role of ultrasound and color Doppler in the evaluation of acute scrotal pain." Bangladesh Medical Journal Khulna 50, no. 1-2 (March 1, 2018): 26–30. http://dx.doi.org/10.3329/bmjk.v50i1-2.35839.

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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
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3

Tapping, Charles R., and James E. Cast. "Scrotal Ultrasound: A Pictorial Review." Ultrasound 16, no. 4 (November 1, 2008): 226–33. http://dx.doi.org/10.1179/174313408x361180.

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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.
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4

Micallef, M., W. C. Torreggiani, M. Hurley, W. W. Dinsmore, and B. Hogan. "The Ultrasound Investigation of Scrotal Swelling." International Journal of STD & AIDS 11, no. 5 (May 2000): 297–302. http://dx.doi.org/10.1177/095646240001100505.

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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.
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5

Biswas, Pintu, and Asim De. "EVALUATION OF SCROTAL PATHOLOGY BY HIGH RESOLUTION ULTRASOUND AND COLOUR DOPPLER." Journal of Evolution of Medical and Dental Sciences 6, no. 34 (April 27, 2017): 2820–27. http://dx.doi.org/10.14260/jemds/2017/607.

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6

Huang, Dean Y., Filippo Pesapane, Vasileios Rafailidis, Annamaria Deganello, Maria E. Sellars, and Paul S. Sidhu. "The role of multiparametric ultrasound in the diagnosis of paediatric scrotal pathology." British Journal of Radiology 93, no. 1110 (June 2020): 20200063. http://dx.doi.org/10.1259/bjr.20200063.

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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.
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7

Ritcey, B. W., M. Woo, M. D. McInnes, J. Watterson, and J. J. Perry. "LO014: What ultrasonography characteristics predict surgical intervention for testicular torsion in adults?" CJEM 18, S1 (May 2016): S35. http://dx.doi.org/10.1017/cem.2016.51.

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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.
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8

Vare, Ajay, Dayanand Kawade, Varsha Rote Kaginalkar, Prashant Titare4, and Samruddhi Sonawane. "Role of ultrasound and colour doppler in assessment of adult scrotal pathologies." MedPulse International Journal of Radiology 6, no. 3 (2018): 57–64. http://dx.doi.org/10.26611/1013633.

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9

Pinggera, G. M., C. Gozzi, L. Pallwein, F. Frauscher, K. Stadlbauer, H. Strasser, G. Bartsch, and A. Schuster. "226Urinary bladder neck blood flow: Comparison of transrectal colour doppler ultrasound to laser doppler flowmetry." European Urology Supplements 4, no. 3 (March 2005): 59. http://dx.doi.org/10.1016/s1569-9056(05)80234-9.

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10

Sermersheim, M. K., B. R. Lindsey, L. M. Naves, M. Rubessa, and M. B. Wheeler. "100 Relationship between corpus luteum blood flow evaluated via colour Doppler ultrasound and pregnancy rate in bovine embryo transfer recipients." Reproduction, Fertility and Development 32, no. 2 (2020): 176. http://dx.doi.org/10.1071/rdv32n2ab100.

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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.
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11

Raj S M, Dheeraj, Ramakrishna Y, and Karthik Aithal. "ROLE OF HIGH FREQUENCY ULTRASOUND AND COLOUR DOPPLER IN EVALUATION OF SCROTAL PATHOLOGIES." Journal of Evolution of Medical and Dental Sciences 6, no. 11 (February 6, 2017): 862–66. http://dx.doi.org/10.14260/jemds/2017/186.

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12

Garcia-Guerra, A., P. L. J. Monteiro Jr, C. A. Gamarra, E. A. Walleser, A. Prata, M. A. Mezera, R. Gennari, et al. "84 Evaluation of indirect methods for pregnancy diagnosis at Day 21 in in vitro-produced embryo transfer recipient heifers." Reproduction, Fertility and Development 31, no. 1 (2019): 167. http://dx.doi.org/10.1071/rdv31n1ab84.

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Early pregnancy detection has the potential to improve reproductive efficiency of embryo transfer (ET) programs by identifying nonpregnant animals and allowing their prompt reutilisation. Although methods are available to determine pregnancy after ~28 days, recent studies have highlighted the potential of indirect measurements, such as colour Doppler ultrasonography of the corpus luteum (CL), to serve as early pregnancy diagnostic methods. The objective of this study was to evaluate the sensitivity, specificity, and positive (PPV) and negative predictive value (NPV) of multiple indirect methods for pregnancy diagnosis at Day 21 in in vitro-produced ET recipients. Dairy heifers (n=796) were synchronized using a modified 5-day CoSynch and received a fresh in vitro-produced embryo 7±1 day after gonadotropin-releasing hormone. Heifers were examined by transrectal ultrasound on Day 21 after gonadotropin-releasing hormone to determine uterine endometrial thickness (UET), CL volume, and CL blood flow. Blood flow to the CL was determined by colour Doppler ultrasonography (Sonovet Pico, 7.5-MHz linear array probe, PRF 1kHz). Blood samples were collected on Day 21 to determine serum progesterone (P4) concentrations. Cutoff points for UET, CL volume, and P4 were evaluated using receiver operating characteristic curves and cutoffs for pregnancy were determined to be <8.75mm, >1800mm3, and >2.65 ng/mL for UET, CL volume, and serum P4, respectively. Heifers were classified as pregnant by CL colour Doppler ultrasound if they exhibited colour pixels in more than 10% of the periphery or exhibited colour pixels internally. Heifers were evaluated by transrectal ultrasonography on Day 28 to determine true pregnancy status. Differences between measurements were determined by generalized estimating equations. Pregnancies per ET on Day 28 was 50.1% (399/796). Sensitivity was lowest for UET and was different (P<0.01) from the other three tests (Table 1). Specificity was greatest (P<0.01) for serum P4, lowest for UET, and intermediate for CL volume and colour Doppler (Table 1). Serum P4, CL volume, and CL colour Doppler showed excellent NPV, indicating that each of these values accurately predicted nonpregnant heifers, the main emphasis of this study. However, PPV was moderate, indicating the potential for false positive results either due to pregnancy loss between Day 21 and 28 or, alternatively, inaccuracy of the method. Thus, on Day 21 of pregnancy, an accurate nonpregnancy diagnosis can be performed in ET recipients by using CL volume with or without CL colour Doppler, allowing for improved reproductive efficiency. Table 1.Sensitivity, specificity, and positive (PPV) and negative predictive value (NPV) for various indirect methods to determine pregnancy on Day 21 in embryo transfer (ET) recipient heifers
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13

Kapto, A. A. "Diagnostic significance of phlebotonometry for evaluation of indications for angioplasty and stenting of compressed iliac veins in patients with varicocele and pelvic congestion disease." Andrology and Genital Surgery 21, no. 1 (April 2, 2020): 29–41. http://dx.doi.org/10.17650/2070-9781-2020-21-1-29-41.

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The aim of the study was to assess the information content of the phlebotonometry method when determining indications for endovascular x-ray angioplasty and stenting of the iliac veins during their arterial compression.Materials and methods. Thirty-six patients with bilateral varicocele and varicose veins of the pelvic organs were examined. The examination included assessment of the condition using the international index of erectile function, ultrasound examination of the scrotum organs with color Doppler mapping, transrectal ultrasound of the prostate and veins of the prostatic plexus, magnetic resonance imaging of the inferior vena cava and pelvic vessels, venography of the renal caval and ileocaval segments, phlebotonometry of these segments in a calm state and during the Valsalva test.Results. Pressure gradient between left and right external iliac veins >2 mm Hg in a calm state was detected in 4 (11.1 %) patients, >3 mm Hg with Valsalva test – in 9 (25.0 %) patients, between the left and right common iliac veins >2 mm Hg in a calm state – in 3 (8.3 %) patients, >3 mm Hg with a Valsalva test, in 15 (41.7 %) patients. At the same time, in 20 (55.6 %) of 36 cases, phlebotonometry data were of a contradictory logic nature, which we attribute to the insufficient sensitivity of this research method. Our data suggest that collateral circulation leads not only to varicose veins of the pelvic organs, but also to equalization of pressure in the ipsilateral segments of the iliac veins due to the law of communicating vessels.Conclusion. Phlebotonometry in the diagnosis of iliac venous compression can only be used as an additional research method. Indications for angioplasty and stenting of the iliac veins during compression should be determined on the basis of clinical data, the severity of varicose veins of the pelvic organs according to the results of transrectal ultrasound examination, the results of magnetic resonance imaging of the inferior vena cava and pelvic vessels (or computed tomography of the abdominal organs with contrast or multispiral computed tomography of the abdominal cavity organs), radiopaque phlebography and intravascular ultrasound.The author declares no conflict of interest.All patients gave written informed consent to participate in the study.
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14

Kapto, A. A. "Syndrome of venous compression neuropathy in patients with pelvic varicose veins." Andrology and Genital Surgery 23, no. 2 (June 23, 2022): 11–18. http://dx.doi.org/10.17650/2070-9781-2022-23-2-11-18.

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The study objective is to investigate the pathogenesis of the development of pelvic symptoms in patients with pelvic varicose veins.Materials and methods. From 2015 to 2022, 145 men with pelvic varicose veins were examined. The examination included questioning of patients using questionnaires (scales) and instrumental methods: 1) ultrasound examination of the scrotum with color Doppler mapping; 2) transrectal ultrasound examination of the prostate and veins of the periprostatic plexus; 3) magnetic resonance imaging of the inferior vena cava and pelvic vessels or computer (multispiral) tomography of the abdominal organs with contrast; 4) phlebography of the renocaval and ileocaval segments.Results. The variant anatomy of fibrous and fibro-osseous canals (tunnels) can explain the fact that with equally pronounced expansion of the pelvic veins, some patients have pelvic symptoms due to nerve compression, while the other part does not. This concept is supported by the fact that in those patients who had complaints of pain, dysuria and erectile dysfunction, after surgical treatment of pelvic varicose veins, in most cases they disappeared or decreased.Conclusion. Pain syndrome (56.6 % of cases), erectile dysfunction (51 % of cases) and dysuria (17.9 % of cases) were noted as clinical manifestations in patients with pelvic varicose veins. Analysis of data after examination and treatment of patients with pelvic varicose veins allowed us to identify “venous compression neuropathy syndrome” as a probable cause of the development of pelvic symptoms in patients with pelvic varicose veins. Depending on the level of localization of nerve compression by varicose veins, we proposed to distinguish three forms of this syndrome: 1) thoracic, 2) lumbar, and 3) sacral form.
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15

Wellert, S. R., S. E. Battista, J. Kieffer, R. N. Lurch, and A. Garcia-Guerra. "168 Comparison of different Doppler ultrasound settings for pregnancy diagnosis based on corpus luteum perfusion at 21 days after AI in beef cattle." Reproduction, Fertility and Development 32, no. 2 (2020): 211. http://dx.doi.org/10.1071/rdv32n2ab168.

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Colour Doppler ultrasonography of the corpus luteum (CL) can be used for early pregnancy diagnosis to improve reproductive efficiency and increase the use of AI in beef cattle. The objective of the present study was to determine the diagnostic performance of different Doppler ultrasonography settings for pregnancy diagnosis based on CL perfusion at 21 days after fixed-time AI in beef heifers and cows. Yearling Angus-cross heifers (n=25) and suckled Angus-cross cows (n=84) aged 2-13 years were submitted to a 5-day CO-Synch + controlled internal drug release (CIDR) and timed AI at 60 or 72h after CIDR removal for heifers and cows, respectively. Animals were evaluated by a single operator using colour Doppler ultrasonography (Esaote MyLab Delta) at Day 21. Three settings for colour flow mapping (720, 960, and 1500Hz) and one setting for power Doppler (960Hz), which differed in pulse repetition frequency, were evaluated. The other settings remained unchanged with a probe frequency of 6.3MHz, wall filter of 3, and gain of 61. The pregnancy status (pregnant or non-pregnant) of cows and heifers was determined at 21 days following insemination using colour Doppler ultrasonography. Cows and heifers were considered to be pregnant if the CL blood flow area covered >10% of the periphery of the CL and contained at least two colour internal tracts penetrating towards the centre of the CL. Cattle were evaluated using transrectal B-mode ultrasonography on Day 35 to determine actual pregnancy status. Differences between diagnostic performance variables were evaluated using logistic regression, and setting, category (heifer or cow), and the interaction were included as fixed effects. Pregnancies per AI at Day 35 after fixed-time AI were 47.7% (52/109). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for pregnancy diagnosis at Day 21 for each setting are included in Table 1. There were no differences in sensitivity and NPV between settings (P>0.9), category (P>0.9), or the interaction (P>0.9). There was no effect of setting (P>0.5) or category×setting interaction (P>0.8) on specificity and PPV. There was, however, an effect of category (P<0.01). Colour Doppler ultrasonography had less specificity (59.1% compared with 90.2%) and PPV (75% compared with 89.3%) in heifers than in cows. In conclusion, colour Doppler ultrasonography settings that were evaluated did not affect the diagnostic performance for pregnancy diagnosis at Day 21 after AI, although, numerically the colour flow mapping at 960Hz appears to maximise diagnostic accuracy. In addition, the false-positive rate was greater in heifers, which warrants further research. Table 1.Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for pregnancy diagnosis for four colour Doppler ultrasound settings (colour flow mapping (CFM) at 720, 960, and 1500Hz and power Doppler (PWD) at 960Hz) at 21 days after fixed-time AI Item CFM720 CFM960 CFM1500 PWD960 Sensitivity,% 100 100 92.3 100 Specificity,% 80.7 87.7 87.7 80.7 PPV,% 82.5 88.1 87.3 82.5 NPV,% 100 100 92.6 100
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16

Ribeiro, I. F., M. G. K. Rodrigues, G. S. Maciel, J. F. Fonseca, F. Z. Brandão, P. M. Bartlewski, and M. E. F. Oliveira. "194 Usefulness of the Ultrasound Imaging Modalities B-Mode and Colour Doppler Sonography and Serum Progesterone Concentrations for Determining Superovulatory Ovarian Responses in Ewes." Reproduction, Fertility and Development 30, no. 1 (2018): 237. http://dx.doi.org/10.1071/rdv30n1ab194.

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The main goal of this study was to assess the usefulness of the 2 imaging modalities—B-mode and colour Doppler sonography—for determining the superovulatory response in ewes. In addition, serum concentrations of progesterone (P4) were examined for correlations with the numbers of laparoscopically detected luteal structures. Oestrus was synchronized in 24 sexually mature Santa Inês ewes with intravaginal P4-releasing devices (CIDR®) inserted for 8 days on a random day of the oestrous cycle. An injection of 37.5 μg of prostaglandin F2α analogue (d-cloprostenol) was given at the time of CIDR® insertion and withdrawal. The superovulatory treatment consisting of 8 consecutive doses of porcine FSH (total dose of 200 or 133 or 100 mg of pFSH; n = 8/total dose) given at 12-h intervals began 48 h before CIDR® removal. All animals received a single injection of 300 IU of eCG concurrently with a first dose of pFSH. On the day of surgical embryo recovery (6 days after the onset of behavioural oestrus), the ovaries of all donor ewes were visualised and examined with transrectal ultrasonography and then with videoendoscopy to identify and enumerate corpora lutea (CL) and luteinized unovulated follicles (LUF). Jugular blood samples were collected just before ovarian imaging for the measurement of circulating P4 concentrations. Ovaries could be easily and repeatedly detected with both the transrectal ultrasonography and videoendoscopic technique. Prematurely regressing CL could not be distinguished from healthy CL using either B-mode or colour Doppler ultrasonography but they were identified by their pale color by using videoendoscopy. All animals responded to the superovulatory treatment and produced ≥4 CL; however, a wide variation in ovarian responses was observed among ewes (range: 4–24 CL/ewe). Three ewes failed to produce healthy CL and had prematurely regressing CL only. In general, LUF were observed in 20/24 ewes (1–5/ewe) and 14/24 ewes had regressing CL (1–22/ewe). The total number of CL (r = 0.78 and 0.83; P < 0.0001) and LUF (r = 0.74 and 0.90; P < 0.0001) enumerated using the B-mode and colour Doppler ultrasonographic technique, respectively, were correlated with that ascertained by videoendoscopy. The determination of the superovulatory response was better by colour Doppler ultrasonography in relation to the B-mode, because it allows a better delimitation of the luteal structures. Serum P4 concentrations were related inversely to the numbers of prematurely regressing CL (r = –0.70; P = 0.0004) and directly to the number of healthy CL (r = 0.69; P = 0.0005). The present results indicate that ultrasonographic imaging and serum P4 measurements on the day of embryo recovery are both very accurate indicators of ovarian responses in superovulated ewes.
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17

Pawar, Upendra, and Sharanbasappa Gubbi. "Clinical evaluation and management of scrotal swelling." International Surgery Journal 8, no. 12 (November 26, 2021): 3601. http://dx.doi.org/10.18203/2349-2902.isj20214752.

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Background: The present study was conducted with the main purpose to identify the mode of presentation, various treatment modalities and outcome of these with their complications.Methods: This prospective study was carried out on a total of 100 subjects presented with scrotal swellings. Exhibiting symptoms were noted including discomfort, painless swelling, urine symptoms and fever. Questionnaires were used to analyse all the predisposing factors of patients, which were then categorized as idiopathic, urinary problems, trauma or previous history. Ultrasound as well as colour Doppler was carried out on all subjects. The options for treatment were either surgical or conservative. The cases treated were recorded accordingly and follow up was done.Results: The majority of study patients, that is, 56%, suffered with scrotal swelling on the right side, followed by left (40%) and bilateral side (4%). 63% of the subjects were presented with symptoms of painless swelling. Whereas 27% of the study subjects were presented with symptoms of pain and fever and 10% of them showed only the symptoms of pain. The majority of study subjects, that is, 71% were treated with surgical modality. Whereas 29% with conservation modality. The most common USG finding found among the study subjects was hydrocoele (37%). 37 (37.0%) subjects having hydrocoele suffered postoperative complications.Conclusions: Younger age group and manual labourers were more prone to scrotal swellings. Few of the operated cases developed postoperative complications like epididymoorchitis. There is a resurgence of thorough clinical examination to establish a diagnosis in patients with scrotal swelling.
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18

Djavan, B., M. Dobrovits, A. Zlotta, T. Anagnestou, W. Horninger, C. Seitz, C. Schulman, G. Bartsch, and M. Marberger. "177 Power colour doppler transrectal ultrasound (PCD-TRUS) can replace biopsy of the anastomotic region in detecting local recurrence following radical prostatectomy." European Urology Supplements 3, no. 2 (February 2004): 47. http://dx.doi.org/10.1016/s1569-9056(04)90178-9.

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19

Shefrin, A. E., B. Ritcey, J. J. Perry, and M. Woo. "MP014: What ultrasonography characteristics predict surgical intervention for children with testicular torsion?" CJEM 18, S1 (May 2016): S71. http://dx.doi.org/10.1017/cem.2016.155.

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Introduction: The timely diagnosis and treatment of testicular torsion is essential as a longer duration of symptoms is correlated with testicular necrosis and infertility. Ultrasound imaging assists in separating this diagnosis from other causes of acute scrotal pain. Our objective was to characterize which ultrasound findings predicted surgical intervention. Methods: We performed a retrospective health records review of all patients, ages 0-17 years that presented to the emergency department of the Children’s Hospital of Eastern Ontario over a 5-year period (2009-14) with scrotal pain <24 hours duration who were assessed by an emergency physician (EP) and received a testicular ultrasound by the Diagnostic Imaging Department. Patients’ records and ultrasound reports were reviewed by two reviewers who recorded ultrasound findings, times of EP assessment, ultrasound and surgical intervention in a standardized data extraction form. Sensitivity, specificity and positive and negative predictive values were calculated for the ultrasound findings. Results: 190 patients were analyzed of which 34 had a final diagnosis of testicular torsion (mean age 11.5 years, range 0-17.3). The mean time from EP assessment to ultrasound was 67.6 minutes (95%CI 50.5-84.6) during the daytime (800-2159) and 83.2 minutes (95%CI 36.7-130.4) for overnight presentations (2200-759). The absence of blood flow on colour Doppler ultrasound of the affected testicle was the best predictor of surgical intervention (sensitivity=94.1% [95%CI 80.3%-99.3%], specificity=99.4% [95%CI 96.5%-99.9%], positive likelihood ratio=146.8 [95%CI 20.7-1037.7] and negative likelihood ratio=0.06 [95%CI 0.02-0.23]. Other ultrasound findings that help rule in testicular torsion were the presence of a heterogeneous testicle on the symptomatic side (specificity=91.0% [95%CI 85.4%-95.0%] and the presence of the whirlpool sign (specificity=99.4% [95%CI 96.5%-99.9%]). Conclusion: The absence of blood flow on ultrasound is the best ultrasound finding for predicting surgical management of testicular torsion. Neither a heterogeneous testicle nor whirlpool sign had strong enough sensitivity to warrant their independent use. Future studies, such as those utilizing point of care ultrasound by EPs, should be conducted to study the affect on delays in treatment.
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20

Camela, E. S. C., R. P. Nociti, V. J. C. Santos, B. I. Macente, G. S. Maciel, M. A. R. Feliciano, W. R. R. Vicente, I. Gill, P. M. Bartlewski, and M. E. F. Oliveira. "151 Associations of Testicular Size and Arterial Blood Flow with Sexual Development and Semen Characteristics in Dorper Rams Raised in a Subtropical Climate." Reproduction, Fertility and Development 30, no. 1 (2018): 215. http://dx.doi.org/10.1071/rdv30n1ab151.

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Spectral Doppler (velocimetric) indices are important indicators of blood perfusion and physiological status of internal organs. Doppler ultrasound is used in andrology to assess the blood flow in the testicular arteries, aiding in the diagnosis of scrotal disorders and abnormal spermatogenesis. It was proposed that blood flow indices measured in the testicular artery, namely, blood flow resistance and pulsatility index, were significant predictors of semen quality in clinically healthy dogs. There is a paucity of studies on the associations of testicular morphology and blood flow dynamics with spermatogenesis in growing rams. Forty-five Dorper rams (24 rams aged 8 to 11 months and 21 rams aged 12 to 24 months) were examined using a portable ultrasound scanner connectecd to a linear-array 7.5-MHz transducer. Measurements of the testes were taken with built-in electronic calipers on images containing the largest cross-sectional area of each testicle in 3 planes (coronal, sagittal, and transverse). Colour and spectral Doppler scans were performed immediately after scrotal ultrasonography to detect the testicular arteries and record the following velocimetric indices: peak systolic velocity (PSV, cm/s), end-diastolic velocity (EDV, cm/s), resistive index (RI = [PSV – EDV)/PSV], and pulsatility index [PI = (SPV – EDV)/mean velocity] of the blood vessels. The length (9.7 ± 0.3 v. 9.0 ± 0.2 cm; mean ± SD) of the testes and scrotal circumference (33.3 ± 0.5 v. 31.8 ± 0.4 cm) were greater (P < 0.05) in sexually mature rams than in peri-pubertal rams. There were no differences (P > 0.05) between the 2 age groups of Dorper rams in mean values for blood flow indices measured in testicular arteries. Semen was collected by ejaculation into the artificial vagina from 38% (8/21) of post-pubertal rams and 21% (5/24) of peri-pubertal animals (Chi-squared test; P < 0.05). Semen volume was negatively correlated with PI of the testicular arteries (r = –0.57, P = 0.04). In summary, the attainment of sexual maturity in Dorper rams maintained in a subtropical climate was associated with significant elongation of testes but not with the changes in testicular volume and blood perfusion. Testicular artery PI was a significant predictor of semen volume in peri-pubertal and sexually mature rams. Based on this and several previous studies, B-mode ultrasonography combined with echotextural analyses of the epididymides and accessory sex glands and serum testosterone measurements provide more useful information on the progression of sexual maturation and present semen quality in rams than the ultrasonographic assessment of testicular dimensions and an array of blood flow indices.
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21

Yotov, S. "Biometric parameters and computer assisted analysis of pixel distribution on B-mode testicular ultrasonogram in young and sexually mature rams." BULGARIAN JOURNAL OF VETERINARY MEDICINE 25, no. 3 (2022): 451–57. http://dx.doi.org/10.15547/bjvm.2370.

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This study was designed to investigate the relationships between basic biometric parameters and pixel distribution in predetermined regions of B-mode testicular ultrasonogram in young and sexually mature rams by computer assisted analysis. The animals were separated in two groups: group I (young rams, aged 5-8 months; n=6) and group II (sexually mature rams, aged 14-18 months; n=6). Biometric parameters as age, body weight and scrotal circumference were determined by routine methods. A trans-scrotal ultrasonography of both testes was performed with 7 MHz linear transrectal probe by the same operator with focus, gain and brightness values kept constant during the study. The ultrasound images were obtained in a longitudinal view plane and frozen when visualisation of the testicular mediastinum was clear and apparent. All images were transferred to a computer, converted to gray-scale (0-255 pixels) and submitted to pixel distribution analysis using Image ProPlus 7.0 analytical software and option range statistics. The pixel distribution analysis in the same region for left and right testes was based on the pixel ranges classification for different biological tissues (blood, lipids, muscle, fibrous and calcium) and expressed as colour area in percentages. The arithmetic mean of values for the left and right testis was accepted as a final value for each ram. The data for both groups were statistically processed, compared and the relationships between the biometric parameters and different pixel ranges were determined. Significant differences (P<0.05) among the groups were recorded for all biometric parameters and the lipid area only. The biometric parameters correlated positively (R≥0.92; P<0.05) each with the other, while their relationship (R≤ -0.94; P<0.05) with the lipid area and the correlation between muscle and fibrous area were negative (R= -0.92; P<0.05). In conclusion, the pixel distribution analysis of a predetermined region of B-mode testicular ultrasonogram based on pixel ranges classification for different biological tissues can be used for detection of testicular parenchyma changes in rams. Future comparative histologic and ultrasound investigations are needed to determine correct pixel values for different biological tissues in the testes of young and sexually mature rams.
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22

Dell’Atti, Lucio. "Ultrasound evaluation of the striated urethral sphincter as a predictive parameter of urinary continence after radical prostatectomy." Archivio Italiano di Urologia e Andrologia 87, no. 4 (January 14, 2016): 317. http://dx.doi.org/10.4081/aiua.2015.4.317.

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Objectives: The purpose of this study was to evaluate preoperatively the results of transrectal ultrasound (TRUS) in the detection of morphological, vascularization status of urethral rhabdosphincter (RS) and evaluate the correlation with urinary continence after radical prostatectomy (RP). Methods: 211 patients who underwent RP were prospectively studied using TRUS scan of the RS thickness. At the end of the examination a study was performed with the use of colour-Doppler for the assessment of the RS vascularity pattern. The level of continence was graded on a 5 point scale as: 1 = complete continence, 2 = 1 pad daily, 3 = 2-3 pads daily, 4 = 4 or more pads daily, and 5 = complete incontinence. Results: It was possible to visualize the rhabdosphincter and its vascularity in all patients. Patients with normal continence (level 1 and 2) showed a sphincter-muscle thickness of 3.5 mm (± 0.4) and a hypoechoic ultrasound pattern. With respect to the other levels 3, 4 and 5 of urinary incontinence RS thickness was 2.8 mm (± 0.5), 2.1 mm (± 0.6), 1.7 (± 0.7) respectively. Incontinence after RP (≥ 3 level) was associated with urethral sphincter deficiency in the great majority of patients. Statistical significant differences were observed in the vascularity between continent and incontinent men in all measured vascularity variables (p &lt; 0.005). Conclusions: This study suggests that RS integrity is a good predictor of urinary continence after RP and this information can be important during the preoperative phase as part of the informed consent.
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23

Pfeifer, L., J. Andrade, E. Moreira, G. Silva, V. Souza, V. Nunes, and L. Siqueira. "164 Gonadotrophin-releasing hormone injection and colour flow Doppler ultrasound of the preovulatory follicle as a tool to increase pregnancy outcome after timed AI in beef cows." Reproduction, Fertility and Development 32, no. 2 (2020): 209. http://dx.doi.org/10.1071/rdv32n2ab164.

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The aims of this study were to determine (1) the association between Doppler vascularisation scores (DVS) of the preovulatory follicle (POF) and fertility of beef cows submitted to timed AI (TAI) and (2) whether cows with low DVS benefit from a gonadotrophin-releasing hormone (GnRH) treatment at TAI. Multiparous lactating Nelore cows (Bos indicus; n=69) from a commercial beef farm in the state of Rondônia, Brazil, were enrolled in this study. Cows received 2mg of oestradiol benzoate intramuscularly (Bioestrogen, Biogénesis Bagó) and an intravaginal progesterone-releasing device (1.9g of progesterone; controlled internal drug release, CIDR) to synchronise follicular wave emergence on Day 0. The CIDR device was removed and cows were treated with 150μg of D-cloprostenol intramuscularly (prostaglandin F2α analogue; Croniben), 1mg of oestradiol cypionate intramuscularly, and 300IU of equine chorionic gonadotrophin (Novormon) intramuscularly on Day 8. Cows were then painted with a tail chalk marker to identify those displaying oestrus. All cows were submitted to TAI 48h after CIDR removal. At TAI, occurrence of oestrus was recorded and all cows were examined using transrectal ultrasonography. Blood flow of the POF was evaluated using colour Doppler imaging. Colour Doppler signals present on the follicular wall were subjectively scored using a 1-to-4 scale (1=absence or very low blood flow, and 4=intense blood flow detected on most of the follicular wall surface) adapted from Ginther (2007Ultrasonic Imaging and Animal Reproduction: Color-Doppler Ultrasonography, pages 87-114). Then, cows were divided into three groups according their DVS of the POF: (1) high DVS (DVS ≥3; n=36), (2) low DVS (DVS &lt;3; n=16), and (3) low DVS (DVS &lt;3; n=17) plus a GnRH treatment at TAI. The diameter of the POF was analysed using analysis of variance (PROC GLIMMIX of SAS; SAS Institute Inc.), and the means were compared among groups using Tukey's test. The proportion of cows that displayed oestrus and pregnancy rates was analysed using chi-square test. Cows in the high-DVS group had a larger POF than cows in the low-DVS and low-DVS-GnRH groups (13.2±0.2, 11.7±0.5, and 12.2±0.4, respectively; P&lt;0.05). The proportion of cows that displayed oestrus was greater (P&lt;0.05) in the high-DVS group (72%, 26/36) than in the low-DVS (37.5%, 6/16) or low-DVS-GnRH (53%, 9/17) groups. Finally, greater (P&lt;0.05) pregnancy rates were observed in cows from the high-DVS (47.2%; 17/36) and low-DVS-GnRH (52.9%; 9/17) groups than in cows from the low-DVS group (18.7%; 3/16). The preliminary results from this study demonstrated that diameter of POF is positively associated with DVS. Moreover, cows that presented POF with higher DVS are more likely to become pregnant, and the administration of GnRH to females with low DVS can increase the fertility of beef cows submitted to TAI protocols. This study received funding support from Embrapa (MP1/PC3 project no. 01.03.14.011.00.00) and from CNPq (universal project no. 407307/2016-8).
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24

Pandey, Shivesh, Suresh Vasant Phatak, Gopidi Sai Nidhi Reddy, and Apoorvi Bharat Shah. "Post Traumatic Hematocele - Ultrasonography and Elastography Imaging." Journal of Evolution of Medical and Dental Sciences 10, no. 21 (May 24, 2021): 1636–38. http://dx.doi.org/10.14260/jemds/2021/340.

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Hematocele with blunt scrotal trauma is an uncommon cause of the testicular pain. Elastography is the new recent advance in the field of ultrasound. USG and elastography findings of the acute hematocele is described in this aricle. Testicular trauma is the third most common cause of acute scrotal pain,1 and high-frequency ultrasonography (USG) with a linear array transducer is the first preferred modality for testicular trauma evaluation. Extra testicular haematoceles or blood collections inside the tunica vaginalis are the most common findings in the scrotum after blunt injury.2 On clinical assessment, haematocele appears as a hard mass like swelling and causes pain in the scrotum. In the majority of cases, spontaneous resolution occurs with the support of conservative therapy,3 even if treated conservatively, may result in infection, discomfort, or atrophy in undiagnosed broad hematoceles and testicular hematomas over time.4 A testis with its coverings, epididymis, and spermatic cord are all contained in each hemiscrotum. A typical testis is 5 x 3 x 2 cm in diameter and has an intermediate echogenicity. The tunica albuginea is a fibrous covering that protects the testis from damage from the external injuries. It is located on top of the tunica vasculosa, which is made up of capsular arteries. A testis with its coverings, epididymis, and spermatic cord are all contained in each hemiscrotum. With its high tensile strength, the tunica albuginea plays an important role in shielding the testis from trauma. It can withstand a force of up to 50 kg without bursting. The testicular parenchyma is made up of several lobules, each of which is made up of several seminiferous tubules that lead to dilated spaces inside the mediastinum called the rete testis through the tubuli recti. The epididymis is made up of a head, neck, and tail that protects the superolateral part of the testis. The epididymis' tail ends in the spermatic cord as the vas deferens. The epididymal head is a 5 – 12 mm pyramidal structure that sits atop the testis' superior pole. The head is almost isoechoic to the testis. The epididymis has a 2 – 4 mm thick body.5 The patient lies in a supine position with the scrotum covered by a towel positioned between the thighs during scrotal ultrasound. A high-frequency lineararray transducer with a frequency range of 7 – 14 MHz is preferred. The scrotum is always soft to the touch after trauma, making scanning difficult. It should be attempted to examine both the testes and the epididymis in their entirety, as well as any extra testicular lesions. The testes are assessed in two planes: longitudinal and transverse. Each testis and epididymis should be compared to the contralateral testis and epididymis in terms of size and echogenicity. Transverse scrotal imaging is important for depicting both testes and comparing their gray-scale and colour Doppler appearances.
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25

Wellert, S. R., S. E. Battista, K. E. Brown, J. D. Kieffer, and A. Garcia-Guerra. "9 Performance of color Doppler ultrasonography of the corpus luteum for pregnancy diagnosis in beef heifers with or without a controlled internal drug release at different days after fixed-time artificial insemination." Reproduction, Fertility and Development 31, no. 1 (2019): 130. http://dx.doi.org/10.1071/rdv31n1ab9.

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Colour Doppler ultrasonography (CDU) of the corpus luteum (CL) has the potential to be used for early pregnancy diagnosis in order to improve reproductive efficiency and increase the use of fixed-time AI (FTAI) in beef cattle. The objective of the present study was to determine the sensitivity and specificity of CDU of the CL for pregnancy diagnosis in beef heifers with or without a CIDR at different days after FTAI. Angus-cross beef heifers (n=84) were synchronized using a 5-day Co-Synch with AI at 60h after CIDR removal. On Day 15 post-AI, heifers were randomly assigned to receive a CIDR (Eazi-Breed CIDR, Zoetis, Parsippany-Troy Hills, NJ) for 9 days or remain as untreated controls. Heifers were evaluated by transrectal CDU (MyLab Delta, Esoate, Genoa, Italy; 7.5-MHz linear array probe, pulse repetition frequency=960Hz) at 15, 17, 20, and 22 days post-AI. Heifers were determined to be pregnant by CDU if colour pixels covered &gt;10% of the periphery of the CL and contained at least 2 colour internal tracts penetrating toward the centre of the CL. Heifers were evaluated by B-mode ultrasonography on Day 28 to determine true pregnancy status. Differences between days and treatments were evaluated using generalized estimating equations. Pregnancies per AI at Day 28 after FTAI were 53.6% (45/84) and were not different between CIDR (52.4%; 22/42) and control (54.8%; 23/42) heifers (P=0.83). Sensitivity and specificity for CIDR and control heifers at different days are shown in Table 1. There was no effect of treatment (P=0.49), day (P=0.99), or treatment by day interaction (P=0.99) on test sensitivity. Specificity was different (P&lt;0.01) between days; however, no treatment (P=0.91) or treatment by day interaction (P=0.82) was identified. Specificity was lowest on Days 15 and 17 and increased to reach its maximum at Day 22. Although no differences between treatments were observed, specificity on Day 22 was numerically greater in CIDR-treated heifers. Positive and negative predictive values for CDU at Day 22 were 84 and 94.1%, respectively, for CIDR-treated heifers and 79.3 and 100%, respectively, for control heifers. Cohen’s Kappa indicated slight (0.19), fair (0.27), moderate (0.50), and substantial (0.73) agreement between conventional ultrasound at Day 28 and CDU at Days 15, 17, 20, and 22, respectively. In summary, CDU showed excellent sensitivity between Days 15 and 22, indicating a very low rate of false-negative results. However, high specificity (low false-positive rate) was achieved only at Day 22. Thus, pregnancy diagnosis by CDU at Day 22 after FTAI coupled with the use of a CIDR may be an effective strategy to identify nonpregnant heifers and attempt their prompt resynchronization. Table 1.Sensitivity and specificity (%) for pregnancy diagnosis by CDU in beef heifers with or without a CIDR at different days after FTAI
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26

Pugliesi, G., F. L. V. Pinaffi, M. A. Beg, and O. J. Ginther. "173 USE OF CORPUS LUTEUM AREA AS A PREDICTOR OF ONGOING FUNCTIONAL LUTEOLYSIS IN DAIRY HEIFERS." Reproduction, Fertility and Development 25, no. 1 (2013): 235. http://dx.doi.org/10.1071/rdv25n1ab173.

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The beginning of functional luteolysis in cattle ranges from Days 16–19 (Day 0 = ovulation). During functional luteolysis, luteal size and blood flow decrease in heifers. The wide range of beginning of luteolysis and the low sensitivity of quick progesterone (P4) assays preclude targeting an individual for a specific period of luteolysis. The present study aimed to evaluate the changes in area and blood flow of corpus luteum (CL) during spontaneous luteolysis and test the hypothesis that a decrease in CL area (cm2) is more efficient in targeting the luteolytic period than using a specific day postovulation. Blood sampling and ultrasound scanning of CL were done every 12 h from Days 13–22 in dairy heifers (Holstein) and was used for a retrospective study (Experiment 1; n = 6 heifers). The P4 concentrations, maximum CL area, and the percentage of CL area with coloured signals of blood flow were centralized to 12-h sample when the end of luteolysis (P4 < 1 ng mL–1) was detected. The percentage decrease in CL area and blood flow between Day 13 and the 12-h sample before the end of luteolysis were calculated. In Experiment 2, a blood sampling and transrectal ultrasonography of CL were performed every 8 h starting on Day 14 to determine the beginning and end of functional luteolysis (n = 20 heifers). The hour of detection of luteolysis was defined as the scan at 8-h intervals when maximum CL area decreased by 25 or 12.5% on Day 14. Based on P4 concentrations, the preluteolytic, luteolytic, and postluteolytic periods in each heifer were identified. The area and blood flow were measured by a duplex B-mode and pulse-wave colour Doppler ultrasound instrument. In Experiment 1, the retrospective study indicated a 25% decrease in CL area and 65% decrease in blood flow 12 h before the end of functional luteolysis. In Experiment 2, the 25% and 12.5% CL area decrease from Day 14 occurred, respectively, on Days 18.1 ± 0.6 and 17.2 ± 0.5 postovulation. The hypothesis that a decrease in CL area is more efficient in targeting ongoing luteolysis than using a specific day postovulation was supported. This was indicated by the greater (P < 0.05) frequency of heifers detected in luteolytic period (12 of 20 heifers) using the criteria of a 12.5% decrease in CL area than using a specific day (Table 1). Using a day postovulation for obtaining heifers in the luteolytic phase was only 0 to 30% effective for targeting luteolysis. In conclusion, the technique of using an ultrasonic 12.5% reduction in CL area is a good tool to detect ongoing luteolysis and may be useful as an experimental design to study factors related to the luteolytic period in cattle. Table 1.Percentage values of heifers in preluteolytic, luteolytic, or postluteolytic periods according to a decrease in CL area criteria or a day postovulation Supported by grants from FAPESP (2012/04004-8 to GP).
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27

Chauhan, Dr Rajnikant Narsinhbhai, and Dr Dileep Kumar Jha. "ROLE OF SONOGRAPHY IMAGING IN MALE INFERTILITY." International Journal of Medical and Biomedical Studies 3, no. 10 (October 30, 2019). http://dx.doi.org/10.32553/ijmbs.v3i10.710.

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Introduction: Infertility is known as major problem as life crisis for many couples. Investigation of male infertility is assuming greater importance with male factors implicated as it caused half of the infertile couples. Infertility is defined as infertility is a disease of reproductive system defined by failure to achieve the clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. It is also define as failure of couple to conceive after 12 months of regular intercourse without the use of contraception in women <35 years; and regular intercourse after 6 months without the use of contraception in women ≥ years. A recent report on the status of infertility in India, states that nearly 50% of infertility is related to the reproductive anomalies or disorders in the male. Male infertility include as pretesticular, testicular and post testicular causes. Common causes may be due to deficiencies in the semen and semen quality is used as a surrogate measure of male fecundity. Testicular causes are mainly cryptorchidism, varicocele exposure to gonadotoxins and post testicular causes which included disorders and obstruction of ejaculation and erectile dysfunction. There are many studies which found that sperm count of less than 10 million per milliliter is also suboptimal for fertility; however there is no cut off value of sperm count that is diagnostic of infertility. The common investigations done in evaluating fertility is Ultrasound examinations of scrotum and semen analysis. Ultrasound is a very useful modality for assessing the testicular size which is also related to condition like epididymo-orchitis, varicocele and undescended testis. Aim: The main aim of this study is to deteremine the used of ultra sonography in the evaluation of male infertility and to compared with clinical and surgical findings. Material and Methods: All the patients were referred to the Department of Radiology for transrectal and scrotal ultrasonography with high frequency transducer having a frequency of 7.5 MHz and Color Doppler wherever indicated. In this study all male patients with infertility and abnormal semen analysis and with the case of infertility with coincident scrotal findings on clinical examination were included. Transrectal ultrasound was done by positioned in left lateral decubitus position. On each side testis and epididymis was identified as completely as possible and compared for symmetry, size, texture and vascularity. Result: In this study patients with abnormality were found in highest number on clinical palpation and ultrasound was varicocele. In 18 cases Varicocele was detected on clinical examination and 24 cases in ultrasound. In 9 cases Hydrocele was detected in clinical examination and Ultrasound. In 5 cases epididymal cysts were detected in clinical findings and 6 cases were found in Ultrasound Findings whereas 2 cases of epididymitis was found in ultrasound and only 1 case in clinical examination. Therefore the total number of abnormalities was found by ultrasound which was significantly greater as compared to physical examination. The p-value was 0.001 which shows statistically significant. Conclusion: Transrectal ultrasound enables high resolution imaging of prostate, seminal vesicles and distal vas deferens and is implicated in diagnosing the cause of obstructive azoospermia. Therefore Imaging plays an important complementary role to clinical examination and laboratory analyses for the detection of precise anatomy and level of abnormality. Hence transrectal and scrotal ultrasound provides valuable information in the diagnostic evaluation of infertile men and pathological conditions can be detected on ultrasound compared to clinical palpation. Keywords: Infertility, Sonography, Transrectal, Testicular
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28

Rathore, Rajesh Kumar, Manav Desai, Krunal Shah, and Bhavya Shah. "Ultrasonography (Grey scale imaging and colour Doppler) in evaluation of acute scrotal pain." International journal of health sciences, May 19, 2022. http://dx.doi.org/10.53730/ijhs.v6ns1.7591.

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Introduction: Ultrasonography with high frequency linear probe and Color Doppler is very important in evaluation of scrotal pathology in patients with acute scrotal pain. Computed tomographyeexposes testicles to theeradiation and MRI is not so easily available. Thereforefultrasound with color Doppler is the bestdsuited modality for the evaluation of scrotal pathologies in patients with acute scrotal pain asqit is simple, noninvasive, reproducible, relatively inexpensive and widely available investigation that will not exposeqthe testis to radiation. Aims and Objectives: Toqclassify (etiologically) and to evaluate various scrotal pathologies in patients with acute scrotal pain using ultrasonography and describe the role of High resolution ultrasound transducer (7-11 MHz) and colour doppler in their diagnosis and differentiation. Materials and Methods: The study was done on 60 patients over period of One year (2021-2022) who were referred to the radiology department by the General Surgery and department of urology for scrotal ultrasound and Doppler study at Dhiraj Hospital,S.B.K.S medical institute and research centre, Pipariya, Waghodia, Baroda. Results: Ofethe 60 patientsestudied, incidence of various pathologies were as follows -inflammatory pathology in 75%, torsion in 13.3%, trauma in 6.7%, and others in 5%. Imaging features of different pathologies causing acute scrotal pain are described.
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29

Ashi, Khalid, Brooke Kirkham, Anil Chauhan, Susan M. Schultz, Bonnie J. Brake, and Chandra M. Sehgal. "Quantitative colour Doppler and greyscale ultrasound for evaluating prostate cancer." Ultrasound, September 9, 2020, 1742271X2095282. http://dx.doi.org/10.1177/1742271x20952825.

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Introduction Although transrectal ultrasound is routinely performed for imaging prostate lesions, colour Doppler imaging visualizing vascularity is not commonly used for diagnosis. The goal of this study was to measure vascular and echogenic differences between malignant and benign lesions of the prostate by quantitative colour Doppler and greyscale transrectal ultrasound. Methods Greyscale and colour Doppler ultrasound images of the prostate were acquired in 16 subjects with biopsy-proven malignant or benign lesions. Echogenicity and microvascular flow velocity of each lesion were measured by quantitative image analysis. Flow velocity was measured over several cardiac cycles and the velocity–time waveform was used to determine microvascular pulsatility index and microvascular resistivity index. The Wilcoxon rank sum test was used to compare the malignant and benign groups. Results Median microvascular flow velocity of the malignant lesions was 1.25 cm/s compared to 0.36 cm/s for the benign lesions. Median pulsatility and resistive indices of the malignant lesions were 1.55 and 0.68, respectively versus 6.38 and 1.0 for the benign lesions. Malignant lesions were more hypoechoic relative to the surrounding tissue, with median echogenicity of 0.24 compared to 0.76 for the benign lesions. The differences between the malignant and benign groups for each measurement were significant (p < 0.01). Conclusion Marked differences were observed in flow velocity, microvascular pulsatility, microvascular resistance, and echogenicity of prostate cancer measured with quantitative colour Doppler and greyscale ultrasound imaging. Vascular differences measured together with echogenicity have the combined potential to characterize malignant and benign prostate lesions.
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30

Ali, Mahamudu A., Mawuenyo Oyortey, Raymond S. Maalman, Otchere Y. Donkor, and Henrietta Quarshie. "Testicular torsion in a catheterized geriatric 73-year-old patient, making an early diagnosis: a case report." Journal of Surgical Case Reports 2021, no. 5 (May 1, 2021). http://dx.doi.org/10.1093/jscr/rjab191.

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Abstract Testicular torsion is a urologic emergency that requires surgical intervention. Its diagnosis is rarely made in elderly men especially the subset of men on urethral catheter. As a result, delayed diagnosis and surgical exploration occur leading to testicular infarction with necrosis, abscess formation and ultimately orchidectomy. We report a 73-year-old urologic patient referred with a 2-month history of transurethral catheterization to relieve retention of urine with subsequent scrotal pains and fever. Physical examination showed left hemi-scrotal swelling and normal right hemi-scrotal findings. A Doppler scan done showed an intratesticular fluid collection with no blood flow in the left testes. This case illustrates the need to include testicular torsion when diagnosing geriatric men with transurethral catheter presenting with any acute scrotal pains. We, therefore, recommend a detailed history and physical examination in addition to a colour Doppler ultrasound scan in making a diagnosis.
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Singh, Bhanupriya, James Marak, Gaurav Raj, Priyanka Rai, Harsha Gara, and Arpan Yadav. "VARIED PRESENTATIONS OF SCROTAL PATHOLOGIES ON HIGH-FREQUENCY ULTRASOUND AND COLOUR DOPPLER WITH REVIEW OF CURRENT KNOWLEDGE." International Journal of Medical Reviews and Case Reports, 2022, 1. http://dx.doi.org/10.5455/ijmrcr.172-1647450344.

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32

Patel, Dhagash, Brijesh Modh, and Kalpesh Bhabhor. "DOES TRANS RECTAL ULTRASOUND (TRUS) HELPS IN DIFFERENTIAL DIAGNOSIS OF PROSTATE LESIONS? A STUDY AT TERTIARY CARE CENTER." GLOBAL JOURNAL FOR RESEARCH ANALYSIS, January 15, 2021, 16–22. http://dx.doi.org/10.36106/gjra/5103496.

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BACKGROUND: There are successions of investigations used in evaluation of prostatic pathology. Currently digital rectal examination & serum PSA levels are used for screening of prostatic cancer. Many conventional imaging techniques like plain radiography, computed tomography, radionuclide scintigraphy and transabdominal sonography were proved to be ineffective in detection of many prostatic conditions specially cancer at an early stage. Transrectal ultrasound (TRUS) has traditionally been considered as the pivotal imaging test for the prostate, providing clinically important information regarding benign and malignant conditions. OBJECTIVES: to evaluate the TRUS and colour Doppler ndings in various benign and malignant prostatic lesions with respect to its site, echo pattern, capsular status, local invasion, vascularity and to correlate with other investigations, like digital rectal examination and serum PSA etc. and also to study the accuracy of TRUS in differentiating benign from malignant lesions. METHODOLOGY: A prospective observational study carried out over a period of 1.5 years at a tertiary care hospital. All male patient referred to department of radio diagnosis with prostate related complains referred from surgery department. Study includes clinical symptoms, family and personal history, laboratory examination like PSA, radiological examination, digital rectal examination. . Various statistical characteristics of the test such as sensitivity, specicity, positive predictive value, negative predictive value were calculated whenever applicable. Out of total 64 patients' recruited OBSERVATIONS: commonest age group was 61 – 70 years (39.1%). Commonest prostatic pathology encountered was BPH (56.2%) followed by prostatic carcinoma (31.3%), prostatitis (4.7%), prostatic abscess & calculus (3.1%) prostatic cyst (1.6%). 75% patients of prostatic carcinoma and 13.9% of Benign Prostate Hypertrophy show PSA value greater than 10ng/ml. Echotexture pattern found on TRUS, in prostatic carcinoma patients was hypoechoic echotexture in 70% patients followed by mixed echotexture in 20% patients. Examination in Color Doppler found, 80 % patients of prostatic carcinoma show increased vascularity and 25 % of benign lesion also shows increased vascularity including all three cases of prostatitis and one out of two case of prostatic abscess. Any single test alone is not helpful in arriving at a diagnosis, but all the thr CONCLUSION: ee tests i.e. PSA level, digital rectal examination, and transrectal ultrasound, together give very conrmatory result, specically to differentiate benign from malignant condition of prostate. . Considering that the initial screening of patients will help in reducing the number of negative biopsies (unnecessary), without impairing the cancer detection capacity.
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CY, Lee, Abu Syazwan, Syed Omar, Syahril Anuar, Islah Munjih, Mohd Nazli, and Hamid Ghazali. "Ruptured Testicular Abscess: A Rare Complication of Epididymo-Orchitis." IIUM Medical Journal Malaysia 18, no. 1 (June 18, 2019). http://dx.doi.org/10.31436/imjm.v18i1.812.

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Epididymo-orchitis is a medical condition characterised by inflammation of epididymis and testis which is a common urological diagnosis encountered by healthcare professionals. Misdiagnosis and under treatment can lead to poor outcome such as infarction and abscess formation. We presented a 33-year-old man, with no known medical illness, presented with one-week history of left testicular pain, swelling and fever. He was commenced on Amoxicillin by his general practitioner. Physical examination showed left swollen and tender testis and normal right testis. Investigations showed an elevated white cell count (WCC) 41.3x103 /L and colour doppler ultrasound (USG) testes showed left epididymo-orhitis. He was admitted and treated with IV Unasyn® (Ampicillin+Sulbactam) for 5 days. His symptoms improved, and he discharged home well with one week oral Unasyn®. He represented 2 weeks later with worsening left scrotal swelling and pain. Clinical examination found a swollen, tender and erythematous scrotum with 1x1cm defect in the left scrotum with purulent discharge. He underwent operation incision and drainage of left scrotum and left orchidectomy. Post-operatively he recovered well. Histopathology reported as epididimoorchitis with abscess, necrosis and perforation. As a conclusion, testicular rupture and abscess formation secondary to epididymo-orchitis is an uncommon reported complication. Immediate recognition and treatment is crucial as a delayed diagnosis can lead to sepsis and infertility.
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