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ABSTRACT: PurposeThe aim of this study was to evaluate the usefulness of imaging for correct clinical and therapeutic management of patients
with scrotal disease.
Materials and methodsBetween 2000 and 2007, 801 patients with suspected scrotal disease underwent colour Doppler ultrasonography (CDUS) at our
centre. In 46 patients, the CDUS study was followed by magnetic resonance imaging (MRI).
ResultsCDUS revealed an inflammatory process in 277 patients (34.58%), testicular trauma in 112 (13.9%), funicular torsion or torsion
of the vestigial remnant in 44 (5.4%), findings suggestive of testicular neoplasm in 35 (4.3%) and no abnormality in 41.5%.
MRI, used to further investigate the CDUS findings in 46 cases, showed three cases of intraparenchymal haematoma, one of intrascrotal
cavernous body rupture, one of testicular abscess with intrascrotal fistula, two of testicular infarction and 15 of neoplasm.
MRI allowed the exclusion of focal abnormalities in ten patients with testicular microlithiasis, in three with chronic orchitis
and in four with atrophic involution. MRI confirmed the finding of inguinal hernia in three cases.
ConclusionsOn the basis of our experience, CDUS is irreplaceable as an initial approach to patients affected by scrotal disease, whereas
MRI is an ideal second-line investigation. MRI offers useful, and in some cases decisive, information, as it is capable of
revealing unexpected findings and elucidating complex aspects. MRI helps improve patient management, with an overall reduction
in costs.
ObiettivoScopo del lavoro è stato quello di valutare l’utilitá delle metodiche di immagine nei pazienti con patologia dello scroto
per un corretto approccio clinico-terapeutico.
Materiali e metodiOttocentouno pazienti sono stati sottoposti ad indagine eco-color Doppler (ECD) e successivamente 46 pazienti sono stati indagati
con risonanza magnetica (RM).
RisultatiL’ECD ha rilevato: in 277 pazienti (34,58%) processo flogistico, in 112 (13,9%) trauma del testicolo, in 44 (5,4%) torsione
del funicolo o di un residuo embrionario, in 35 (4,3%) alterazioni riconducibili ad eteroplasia testicolare mentre nel 41,5%
non erano presenti alterazioni patologiche. In 46 casi si è ricorsi alla RM per chiarimento o miglior definizione diagnostica
del reperto ECD rilevando: 3 casi di ematoma intraparenchimale, 1 caso di rottura intrascrotale del corpo cavernoso, 1 caso
di ascesso testicolare con fistola intrascrotale, 2 casi di infarto, 15 casi di eteroplasia. Inoltre ha permesso di escludere
alterazioni focali in 10 pazienti affetti da microlitiasi testicolare (MT), in 3 con orchite cronica e in 4 con involuzione
atrofica. In 3 casi ha confermato il reperto di ernia inguinale.
ConclusioniDalla nostra esperienza l’indagine ECD appare di insostituibile utilitá nel primo approccio ai pazienti con patologia scrotale
e l’indagine RM rappresenta un ideale metodica di secondo livello. La RM è utile in casi selezionati, potendo rilevare situazioni
complesse e precedentemente insospettabili, risultando in un miglioramento della gestione del paziente e in un contenimento
globale dei costi.
La radiologia medica 04/2012; 114(3):414-424. · 1.44 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to evaluate the usefulness of imaging for correct clinical and therapeutic management of patients with scrotal disease.
Between 2000 and 2007, 801 patients with suspected scrotal disease underwent colour Doppler ultrasonography (CDUS) at our centre. In 46 patients, the CDUS study was followed by magnetic resonance imaging (MRI).
CDUS revealed an inflammatory process in 277 patients (34.58%), testicular trauma in 112 (13.9%), funicular torsion or torsion of the vestigial remnant in 44 (5.4%), findings suggestive of testicular neoplasm in 35 (4.3%) and no abnormality in 41.5%. MRI, used to further investigate the CDUS findings in 46 cases, showed three cases of intraparenchymal haematoma, one of intrascrotal cavernous body rupture, one of testicular abscess with intrascrotal fistula, two of testicular infarction and 15 of neoplasm. MRI allowed the exclusion of focal abnormalities in ten patients with testicular microlithiasis, in three with chronic orchitis and in four with atrophic involution. MRI confirmed the finding of inguinal hernia in three cases.
On the basis of our experience, CDUS is irreplaceable as an initial approach to patients affected by scrotal disease, whereas MRI is an ideal second-line investigation. MRI offers useful, and in some cases decisive, information, as it is capable of revealing unexpected findings and elucidating complex aspects. MRI helps improve patient management, with an overall reduction in costs.
La radiologia medica 04/2009; 114(3):414-24. · 1.44 Impact Factor
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[hide abstract]
ABSTRACT: The aim of this study was to evaluate the utility of color-Doppler ultrasound (CDUS) in detecting haemodynamically significant in-stent restenosis in patients who underwent endoluminal renal artery revascularisation by stent deployment.
Between January 2000 and December 2006, 42 patients (nine women and 33 men, age range 45-87 years) treated by endovascular renal artery stenting were studied with CDUS. Renal artery haemodynamics were evaluated to identify haemodynamically significant restenosis. Patients with CDUS signs of restenosis underwent angiography for a possible further revascularisation procedure.
Of 42 patients examined by CDUS, 13 (31%) showed signs of haemodynamically significant in-stent renal artery restenosis. Of these 13, three did not undergo endoluminal renal artery revascularisation because renal ischaemia deterioration and irreversible renal circulation impairment. In the remaining ten patients (23.8%), who had no signs of severe nephropathy, angiography confirmed the CDUS findings of in-stent restenosis in all cases. Restenoses were successfully treated by a repeat endovascular revascularisation procedure.
Our results confirm the fundamental role of CDUS in the follow-up of patients after renal artery stenting. It enables early restenosis detection and evaluation of renovascular disease associated with renal artery stenosis. CDUS provides essential information for the subsequent clinical management of these patients.
La radiologia medica 04/2008; 113(2):242-8. · 1.44 Impact Factor
