Correlation of diagnostic ultrasound and radionuclide imaging in scrotal disease

A retrospective study was performed to evaluate the usefulness of scrotal ultrasound imaging (SU) and radionuclide scrotal imaging (RSI) in 43 patients (pts), age: 16-75. Twenty-two of them complained of scrotal pain; 18 had a scrotal mass; and 4 had a history of trauma. The final diagnoses were conformed by surgery (n = 21) and long-term follow-up (n = 22) and included 4 late phase and 1 early testicular torsion (TT), 11 acute epididymitis (AE), 4 subacute epididymitis (SE), 5 malignant tumors, 3 testicular atrophy, 2 intratesticular hematomas, 10 hydroceles or other cystic lesions, and miscellaneous. In pts with scrotal pain, 3/4 with late phase TT were correctly diagnosed, while one pt with early TT and 11/15 with AE or SE were not diagnosed by SU. All of them were correctly diagnosed with RSI except one with scrotal cyst. SU was able to separate cystic masses (n = 10) from solid masses (n = 6), but cannot separate malignant from benign lesions. SU was excellent in detecting 19 hydroceles and 2 intratesticular hematomas, while 3 lesions < 1 cm. were not seen in RSI. The authors concluded that SU is useful in pts with scrotal mass to separate solid from cystic lesions. However, SU is unable to differentiate the acute epididymitis from early testicular torsion. In pts with acute scrotal pain, SU is not helpful and RSI should still be the first study performed