MRI Pelvis (Scrotum) Without IV Contrast MRI of the pelvis without IV contrast is not routinely used as an initial imaging modality for the evaluation of acute scrotal pain without trauma and without antecedent mass. There is no relevant literature regarding the use of MRI of the pelvis without IV contrast in these patients. Nuclear Medicine Scan Scrotum Radionuclide scrotal imaging (RNSI) has been replaced by Doppler US as the primary imaging modality for evaluation of the acute scrotum. RSNI has a reported sensitivity and specificity for differentiation between testicular torsion and epididymoorchitis from 89% to 98% and 90% to 100%, respectively [68,69]. RSNI is limited by technical challenges in children whose small genitalia are difficult to image with radiotracers. RNSI also can have photon-deficient areas secondary to hydrocele, spermatocele, and inguinal hernias, which can be erroneously diagnosed as avascular testis [70]. US Duplex Doppler Scrotum Spectral analysis of the Doppler waveform allows a quantitative assessment of organ perfusion. Acute Onset of Scrotal Pain contralateral testicle or a different region within the same testicle. Variability of the amplitude was the most common abnormality, followed by reversal of diastolic flow [6]. Additional characteristic spectral Doppler waveforms seen in partial testicular torsion include monophasic waveform, tardus-parvus morphology, and spectral Doppler waveform variations within the same testis, all worrisome for underlying ischemia. Spectral Doppler analysis should be performed in the upper, mid, and lower poles of each testicle [6,72,74]. US Scrotum US is the established first-line imaging modality for acute scrotal disease [75] and can be used to diagnose most scrotal disorders when combined with clinical history and physical examination. US is generally well tolerated and widely available, making it ideal for scrotal evaluation.
Acute Onset of Scrotal Pain Without Trauma Without Antecedent Mass. MRI Pelvis (Scrotum) Without IV Contrast MRI of the pelvis without IV contrast is not routinely used as an initial imaging modality for the evaluation of acute scrotal pain without trauma and without antecedent mass. There is no relevant literature regarding the use of MRI of the pelvis without IV contrast in these patients. Nuclear Medicine Scan Scrotum Radionuclide scrotal imaging (RNSI) has been replaced by Doppler US as the primary imaging modality for evaluation of the acute scrotum. RSNI has a reported sensitivity and specificity for differentiation between testicular torsion and epididymoorchitis from 89% to 98% and 90% to 100%, respectively [68,69]. RSNI is limited by technical challenges in children whose small genitalia are difficult to image with radiotracers. RNSI also can have photon-deficient areas secondary to hydrocele, spermatocele, and inguinal hernias, which can be erroneously diagnosed as avascular testis [70]. US Duplex Doppler Scrotum Spectral analysis of the Doppler waveform allows a quantitative assessment of organ perfusion. Acute Onset of Scrotal Pain contralateral testicle or a different region within the same testicle. Variability of the amplitude was the most common abnormality, followed by reversal of diastolic flow [6]. Additional characteristic spectral Doppler waveforms seen in partial testicular torsion include monophasic waveform, tardus-parvus morphology, and spectral Doppler waveform variations within the same testis, all worrisome for underlying ischemia. Spectral Doppler analysis should be performed in the upper, mid, and lower poles of each testicle [6,72,74]. US Scrotum US is the established first-line imaging modality for acute scrotal disease [75] and can be used to diagnose most scrotal disorders when combined with clinical history and physical examination. US is generally well tolerated and widely available, making it ideal for scrotal evaluation.