[Color-Doppler echography of the testis. Study technique and vascular anatomy]

Abstract

Color-Doppler sonography has recently made it possible to image scrotal vascularity non-invasively. This study was undertaken to determine the normal color-Doppler appearance and distribution of scrotal vessels and to define the technical principles of the examination. Color-Doppler imaging was effective in detecting both funicolar and testicular vessels. Among these, capsular (25/25), trans-testicular (10/25), centripetal and recurrent (25/25) arteries were easily identified. Waveforms analysis allowed to differentiate veins from arteries within testis and to distinguish (8/10) supratesticular (high impedance pattern with absent diastolic flow) from intratesticular arteries (low impedance pattern with high levels of diastolic flow). The optimal color depiction of scrotal vascularity needed the appropriate selection of several imaging parameters to increase detection of low-velocity, low-volume flows within the small testicular vessels. Such parameters included: PRF (ranging 1500 to 600 Hz), wall filters (ranging 25 to 50 Hz), color gain (maximized for optimal sensitivity while avoiding excessive color noise), color vs. echo priority (ranging 70 to 90%) and color persistence (adjusted to high values). In conclusion, color-Doppler imaging is capable of reliably showing the normal anatomy of testicular vessels. It could make a reliable substitute for scintigraphy and continuous wave Doppler in diagnosing scrotal conditions that alter blood flow.