ARRS 2022 Abstracts


E1195. Interpretation of Spectral Doppler Waveforms in the Testes
  1. Priyanka Garg; University of Rochester Medical Center
  2. Vikram Dogra; University of Rochester Medical Center
  3. Akshya Gupta; University of Rochester Medical Center
Interpretation of spectral Doppler waveforms is key to the diagnosis of the underlying cause of acute scrotal pain. The purpose of this exhibit is to understand normal Doppler waveforms and variations in waveforms that can point towards the diagnosis. The spectral Doppler waveform in complete testicular torsion and incomplete testicular torsion will be explored, including tardus parvus waveforms, reversal of diastolic flow, and asymmetry in waveforms in the same testes. A differential diagnosis of testicular ischemia will be presented to differentiate testicular torsion from ischemia related to extrinsic compression of the spermatic cord from an incarcerated hernia, vasculitis, and drug-induced ischemia.

Educational Goals / Teaching Points
The attendee will be able to understand normal spectral Doppler waveforms of the testes; understand the abnormal spectral Doppler waveforms in partial torsion and appreciate the significance of tradus parvus waveform, reversal of diastolic flow in the testicular artery, and asymmetry in the spectral Doppler waveforms in the same testes; understand and describe the spermatic cord twist/knot sign and understand it's significance; and differentiate between ischemia from testicular torsion and ischemia from other causes in the testes. Mimics of the testicular torsion will also be presented.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit includes: normal spectral Doppler waveform of the testes; tardus parvus waveform; reversal of diastolic flow in the testicular artery; and spermatic cord twist/knot sign.

Testicular gray-scale ultrasound is the modality of choice for imaging evaluation of acute scrotal pain. The detection of subtle variations in spectral Doppler waveforms is crucial to identify patients who need surgical or medical management in the setting of scrotal pain.