Value of ultrasound findings of the scrotum and testes

Abstract

Ultrazvuk je zbog visoke osjetljivosti i specifičnosti danas zlatni standard u otkrivanju bolesti testisa i skrotuma budući da mnoga stanja ove regije mogu biti obilježena jednakom kliničkom slikom. Ova retrospektivna studija prikazuje sve ultrazvučne nalaze testisa i skrotuma Zavoda za dijagnostičku i intervencijsku radiologiju KBC-a Zagreb ostvarenih u jednoj kalendarskoj godini. Tako je u 2017. pregledano 853 muškaraca, od kojih je 81% bilo mlađe od 50 godina. U većini nalaza, odnosno 79% ispitanika, pronađena su odstupanja od uredne anatomske strukture. Dominantan udio imaju nalazi varikokela prisutni u 35.7% i cisti u 30.1% pacijenata. Lijeva varikokela je zbog anatomskih zakonitosti zastupljena sa 86% udjelom, a izolirana desnostrana u svega 4%. Većina benignih cističnih lezija (92%) je pronađena u epididimisu, a ostatak u testisu. Akutna stanja čine 11% nalaza, među kojima je najviše upala (7.7%), torzija (1.9%), tumora (1%) i stanja traumatske etiologije (0.4%). Značajan je broj orhidektomiranih muškaraca (n=97) u kontroli među kojima većina ima uredan nalaz ostatnog testisa (62%), a od češćih stanja koja odstupaju od normalnog su kalcifikati, varikokele i ciste. Sterilnost muškaraca je sve učestaliji problem u svijetu. 4% pacijenata pregledano je sa uputnom dijagnozom steriliteta i utvrđeno da njih 27% ima uredan ultrazvučni nalaz, dok je u većine nađeno odstupanje. Nalazi varikokela, hipotrofije testisa i kalcifikata su najviše zastupljeni u onih upućenih zbog steriliteta.Nowadays, due to its high sensitivity and specificities, the ultrasound is the golden standard in the diagnosis of the diseases of the testes and scrotum since many conditions of that region can be included in the same clinical picture. This retrospective study provides an overview of all ultrasound findings of the testes and scrotum at the Institute for Diagnostic and Interventional Radiology of the UHC Zagreb in the course of one calendar year. In 2017, 853 men were examined, out of which 81 % were below 50 years of age. In most of the findings, namely 79 % of patients, there were deviations from the normal anatomical structure. The findings of varicocele, present in 35.7 % of patients, and cysts, present in 30.1 % of patients, are the most frequent. Due to the anatomical principles, the left varicocele makes up 86 %, while cases of isolated right-sided varicoceles makes up only 4 %. 92 % of benign cystic lesions were found in the epididymis, and the rest of them in the testis. Acute conditions make up 11 % of findings, among which inflammations (7.7 %), torsions (1.9 %), tumours (1 %) and conditions indicative of a traumatic etiology (0.4 %) are prevalent. There is a significant number of orchidectomised men (n=97) in the control group, most of which have a normal result for the remaining testis (62 %), with calcificates, varicocele and cysts being among the most frequent conditions that deviate from the norm. Male sterility is an increasingly frequent problem in the world. 4 % of patients were examined with an incidental diagnosis of sterility, 27 % of them with a normal ultrasound finding, but with a deviation in most of them. Varicocele, hypotrophy of the testes and calcificates are the most prevalent in those patient referred for sterility