Abnormal testicular Doppler flow (differential)
Last revised by Yusra Sheikh on 4 Nov 2021
Citation, DOI, disclosures and article data
Citation:
Morgan M, Sheikh Y, Jones J, et al. Abnormal testicular Doppler flow (differential). Reference article, Radiopaedia.org (Accessed on 16 Apr 2024) https://doi.org/10.53347/rID-75832
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rID:
75832
Article created:
8 Apr 2020,
Matt A. Morgan ◉
Disclosures:
At the time the article was created Matt A. Morgan had no recorded disclosures.
View Matt A. Morgan's current disclosures
Last revised:
4 Nov 2021,
Yusra Sheikh ◉
Disclosures:
At the time the article was last revised Yusra Sheikh had no recorded disclosures.
View Yusra Sheikh's current disclosures
Revisions:
8 times, by
7 contributors -
see full revision history and disclosures
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Abnormal testicular Doppler flow (arterial, venous, or both) can be a differential challenge. Always remember that the patient's presenting history helps quite a bit in narrowing the differential.
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Reduced flow
- partial testicular torsion (<360 degrees)
- venous outflow is obstructed first, resulting in high resistance arterial waveforms
-
testicular ischemia/infarction
- most often a result of torsion or untreated infection
- testicular fibrosis
- extrinsic compression of the testicular and deferential arteries
- e.g. inguinal hernia
- acute hydrocele
- may produce subclinical alterations in intra-testicular vascular impedance 4
- high-resistance spectral Doppler patterns may normalize after evacuation of the collection 3
- may rarely cause sufficient intra-tunical pressure elevation to exert a physiology akin to compartment syndrome with resultant testicular ischemia 2
- may produce subclinical alterations in intra-testicular vascular impedance 4
- testicular rupture
Absent flow
- complete testicular torsion (both arteries and veins are obstructed)
- extrinsic compression of the testicular and deferential arteries
- e.g. inguinal hernia
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Increased flow
- epididymo-orchitis or isolated orchitis (less common)
- testicular neoplasm
- reperfusion phase of intermittent torsion
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References
- 1. Alexander LF, Caserta MP, Baden K, Livingston D, Cernigliaro JG, Bhatt S. Absent, Abnormal, or Reduced Flow in the Testis: Thinking Beyond Torsion. (2020) Radiographics : a review publication of the Radiological Society of North America, Inc. 40 (2): 529-530. doi:10.1148/rg.2020190111 - Pubmed
- 2. Douglas JW, Hicks JA, Manners J, Hayes MC. A pressing diagnosis - a compromised testicle secondary to compartment syndrome. (2008) Annals of the Royal College of Surgeons of England. 90 (2): W6-8. doi:10.1308/147870808X257184 - Pubmed
- 3. Wright L, Gerscovich E, Corwin M, Lynch L, Lamba R. Tension Hydrocele: Additional Cause of Ischemia of the Testis. Journal of Ultrasound in Medicine. 2012;31(12):2041-3. doi:10.7863/jum.2012.31.12.2041 - Pubmed
- 4. Luke A. Wright, Eugenio O. Gerscovich, Michael T. Corwin, Lisa Lynch, Ramit Lamba. Tension Hydrocele: Additional Cause of Ischemia of the Testis. (2012) Journal of Ultrasound in Medicine. 31 (12): 2041. doi:10.7863/jum.2012.31.12.2041
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