Ultrasonography of intrascrotal torsed appendages: size and interval between symptom onset and the ultrasonographic examination according to echogenicity

• Published in: Ultrasonography Vol. 42; no. 2; pp. 259 - 264
• Main Authors: Lim, Seung-Hyun, Yang, Dal Mo, Kim, Hyun Cheol, Kim, Sang Won, Kim, Hyunmin, Lee, Da In, Moon, Sung Kyung, Park, Seung Jin
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Ultrasound in Medicine 01.04.2023
• Subjects: appendix epididymis; appendix testis; color doppler ultrasonography; Hemorrhage; Original; scrotum; torsion; Ultrasonic imaging; ultrasonography; Variance analysis; United States > US; Scrotum; Appendix testis; Appendix epididymis; Color Doppler ultrasonography; Torsion; Ultrasonography
• ISSN: 2288-5919; 2288-5943
• DOI: 10.14366/usg.22169

Purpose: This study investigated the size of torsed appendages and the interval between symptom onset and the ultrasonographic examination according to the echogenicity of the torsed appendages.Methods: This was a retrospective analysis of 54 cases in 46 patients with torsion of the testicular appendages between December 2008 and July 2021. Eight patients received follow-up ultrasonography 7-48 days after initial ultrasonography. The echogenicity of torsed appendages was classified into three groups: hypoechoic, hyperechoic, or isoechoic.Results: The 54 torsed appendages were hypoechoic (n=40), hyperechoic (n=9), or isoechoic (n=5). The size of the torsed appendages ranged from 4 to 14 mm (8.0±3.1 mm) in hypoechoic torsed appendages and from 2.6 to 5.0 mm (3.7±0.9 mm) in hyperechoic torsed appendages. The interval between symptom onset and the ultrasonographic examination ranged from 0 to 17 days (4.2±4.4 days) in hypoechoic torsed appendages and from 8 to 48 days (29.8±16.0 days) in hyperechoic torsed appendages. The hyperechoic torsed appendages were smaller and had longer intervals between symptom onset and the ultrasonographic examination than the hypoechoic torsed appendages (P<0.05). Three hypoechoic torsed appendages and a single isoechoic torsed appendage on initial ultrasonography became hyperechoic on follow-up ultrasonography.Conclusion: The size of the torsed appendages and the interval between symptom onset and the ultrasonographic examination varied according to the echogenicity of the torsed appendages. The hyperechoic torsed appendages were smaller and had longer intervals until the examination than the hypoechoic torsed appendages.