The significance of scrotal scintigraphy for varicocele

The purpose of this study is to develop a non-invasive diagnostic method for varicocele and reflux of internal spermatic vein (ISV) by scrotal scintigraphy. The subjects consisted of 90 males with infertility and scrotal areas pain ranging from 13 to 61 years of age. The severity of varicocele was classified in Grade 0 to 3, based on Suzuki's classification. Scrotal scintigraphy was taken with 99mTc-HSA-DTPA (740 MBq). Upright dynamic image, upright and supine static image were obtained. On scrotal scintigraphy, the severity was classified by time-activity curve (TAC) pattern on dynamic study in scrotal area, and position and venous pool in varicocele on a static image. TAC pattern of rapid filling and rapid drainage on dynamic image was seen in most of the Grade 3 cases. The position and venous pool were more clearly demonstrated in the upright than in the supine study, due to gravitational effect. In Grade 2 and 3 cases, venous pool was prominent. Scrotal scintigraphy is useful to assess the varicocele by means of identification of its position, hemodynamics analysis, and measurement of venous pool. (author)