EVALUATION OF EPIDIDYMORCHITIS BY HIGH FREQUENCY GRAY SCALE AND COLOR DOPPLER ULTRASONOGRAPHY

Abstract

INTRODUCTION: Ultrasonography is extremely well suited to study of scrotum and its contents. Ultrasound is simple to perform, quick, non-invasive, low cost effective, easily reproducible, widely available and does not involve irradiation of gonads.It is very helpful in differentiating intratesticular and extratesticular pathologies. Ultrasound is the modality to differentiate solid from cystic lesions of testes and with the introduction of color Doppler, it becomes easiear to assess the viability of testis in cases of torsion and guiding the treatment accordingly. USG is helpful in differentiating torsion/ischaemia of testis from the acute inammatory pathologies. Role of other Modalities: CT and MRI have dominated imaging of other regions of the body, they have certain restrictions in evaluation of scrotal diseases. Computed Tomography delivers radiation to gonads, On the contrary, MRI imaging is expensive and not readily obtainable. Radionuclide scan helps in equivocal presentations to assess vascularity within the testis in setting of torsion but its readily availability and cost is the main set back. AIM: To assess the role of high frequency gray scale and color doppler ultrasonography in evaluation of epididymorchitis. MATERIAL & METHODS: SAMPLE: 50 cases of scrotal pathology were taken using High-frequency real time gray scale ultrasonography and Color Doppler . Patients were referred to our department for scrotal ultrasonography and Doppler study by department of Urology and department of Surgery of SRMS IMS Bareilly. RESULTS: In the present study total evaluated cases of epididymoorchitis were 15,among them 11 cases were acute and 4 cases were of chronic epididymoorchitis.. Majority of cases were having unilateral involvement with 1 case of B/L involvement. USG gray scale found heterogenous echogenicity or reduced echogenicity in acute EPO while the echogenicity was reduced with calcication in chronic EPO. .Doppler study found increased vascularity in majority of cases of acute EPO with reactive hydrocele while vascularity was either normal or increased in chronic EPO without any reactive hydrocele. CONCLUSION: High-frequency gray scale USG helps in clear evaluation of anatomical structural alterations associated with acute scrotal inammatory diseases, and color Doppler USG is highly sensitive in diagnosing acute scrotal pathology. In addition, Color Doppler USG accurately differentiates between testicular ischemia and torsion from acute inammatory diseases in acute painful scrotal conditions.