Usefulness of scrotal scintigraphy for infertile males with varicocele

We studied the scrotal scintigraphy on twenty infertile males suspected of having varicocele in order to detect diagnostic accuracy. All patients were examined by renal and internal spermatic venographies, and three of the patients were examined by scrotal scintigrams with direct renal venoscintigraphy, which is well known for revealing the true reflux from the renal to the internal spermatic veins. The results were as follows: 1) Early uptake imagings and time activity curves obtained from scrotal scintigraphy and direct renal venoscintigraphy presented identical findings. 2) Time activity curves were classified into four patterns according to registration patterns of scrotal scintigram and early uptake imagings. Pattern I (rapidly increasing activity at early phase of the curve and the image, left side only) and Pattern II (same as Pattern I, but right side accompanied by delayed accumulation) reliably indicated varicocele. Pattern III (gradually increasing activity curve of both sides) indicated left sided varicocele, not right sided. This pattern was scintigraphically difficult to diagnose as evidence of varicocele. Pattern O (slowly increasing activity of the curve, no early phase of the image) indicated no evidence of varicocele. 3) Scrotal scintigraphy was thought to be one of useful means on detection of varicocele and follow-up studies. (author)