Diagnostic Value of Superb Microvascular Imaging in Testicular Torsion-A Case Report

Testicular torsion accounts for 25–35% of pediatric scrotal emergency; thus, early diagnosis is crucial to avoid testicular loss due to the severity of ischemia depending on the torsion duration. Sometimes, it is difficult to make a definite diagnosis with conventional Doppler imaging techniques (Color Doppler(CD), Power Doppler (PD)) especially in pediatric patients in small testes volume. In this patient group, testis torsion diagnosis cannot be made because no vascular flow can be observed on normal and affected sides via CD and PD examinations, because the testes volume is small. Superb micro-vascular imaging (SMI), an innovative new Doppler technology designed to overcome the limitations of conventional Doppler imaging techniques, is used to determine microvascular blood flow. In such cases, by adding SMI to the examination, testis torsion diagnosis can be made earlier with high accuracy. In this case, due to failure to observe vascular flow via SMI on the affected side of a 5 year old patient, he was diagnosed with intravaginal torsion undoubtfully in a short period of time by showing the intratesticular vascular flows on the normal side, and the intravaginal torsion diagnosis was verified by surgery.

Keywords: Intratesticular vascular flow, Superb microvascular imaging, testicular torsion.