Application of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysis

Abstract Background Acute complete testicular torsion, acute incomplete testicular torsion, acute testicular ischemia, acute testicular appendage torsion, and acute epididymo-orchitis are common scrotal emergencies in urology. An accurate diagnosis of the cause of acute scrotal pain is crucial for s...

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Main Authors: Bin Zou, Yuling Yang, Lusheng Zhang, Huabin Chen, Fuqiang Zeng, Biwei Chen
Format: Article
Language:English
Published: BMC 2025-08-01
Series:International Journal of Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12245-025-00944-x
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author Bin Zou
Yuling Yang
Lusheng Zhang
Huabin Chen
Fuqiang Zeng
Biwei Chen
author_facet Bin Zou
Yuling Yang
Lusheng Zhang
Huabin Chen
Fuqiang Zeng
Biwei Chen
author_sort Bin Zou
collection DOAJ
description Abstract Background Acute complete testicular torsion, acute incomplete testicular torsion, acute testicular ischemia, acute testicular appendage torsion, and acute epididymo-orchitis are common scrotal emergencies in urology. An accurate diagnosis of the cause of acute scrotal pain is crucial for selecting the appropriate treatment. This study aimed to explore the application of high-frequency ultrasonography (HFUS) and contrast-enhanced ultrasonography (CEUS) in the evaluation of acute scrotal lesions. Results This study included 46 patients with acute scrotal pain. All patients underwent HFUS and CEUS prior to treatment. The ultrasonographic features of the affected and contralateral (healthy) testes were compared to evaluate the application of HFUS and CEUS for the assessment of acute scrotal lesions. Two patients with testicular ischemia were correctly diagnosed using both HFUS and CEUS. Among the nine patients with complete testicular torsion, eight were correctly diagnosed using HFUS, while one was only diagnosed as having an abnormal testis. In the cohort of 11 patients with incomplete testicular torsion, eight were accurately identified using HFUS, whereas three were erroneously diagnosed as having complete testicular torsion. Among the 15 patients with testicular appendage torsion, 14 were correctly diagnosed using HFUS, while one was misdiagnosed as having testicular torsion. Among the nine patients with epididymitis, seven were correctly diagnosed using HFUS, one was misdiagnosed as having testicular appendage torsion, and one was misdiagnosed as normal. However, CEUS results were consistent with the final confirmed diagnoses. The diagnostic accuracy of HFUS for acute scrotal lesions was 84.8%, whereas that of CEUS was 100%. The discrepancy between the two methods was statistically significant (χ2 = 3.50; P = 0.018, P < 0.05, respectively). Conclusion CEUS has higher accuracy in evaluating acute scrotal lesions. This can prevent misjudgment of the degree of testicular torsion, prevent misdiagnosis of testicular appendage torsion and epididymitis as testicular torsion, and avoid misjudgment of abnormal testes or epididymitides as normal. This helps prevent adverse outcomes such as delayed treatment and testicular removal.
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spelling doaj-art-5a8aa2c2db6c4fadb5444c83877dbd1f2025-08-20T03:42:23ZengBMCInternational Journal of Emergency Medicine1865-13802025-08-011811910.1186/s12245-025-00944-xApplication of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysisBin Zou0Yuling Yang1Lusheng Zhang2Huabin Chen3Fuqiang Zeng4Biwei Chen5Department of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese MedicineDepartment of Medical Imaging, Zhongshan Hospital of Traditional Chinese Medicine, The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese MedicineDepartment of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese MedicineDepartment of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese MedicineDepartment of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese MedicineReception room of the Medical Department & The Doctor-Patient Relations Department, Zhongshan Hospital of Traditional Chinese Medicine, The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese MedicineAbstract Background Acute complete testicular torsion, acute incomplete testicular torsion, acute testicular ischemia, acute testicular appendage torsion, and acute epididymo-orchitis are common scrotal emergencies in urology. An accurate diagnosis of the cause of acute scrotal pain is crucial for selecting the appropriate treatment. This study aimed to explore the application of high-frequency ultrasonography (HFUS) and contrast-enhanced ultrasonography (CEUS) in the evaluation of acute scrotal lesions. Results This study included 46 patients with acute scrotal pain. All patients underwent HFUS and CEUS prior to treatment. The ultrasonographic features of the affected and contralateral (healthy) testes were compared to evaluate the application of HFUS and CEUS for the assessment of acute scrotal lesions. Two patients with testicular ischemia were correctly diagnosed using both HFUS and CEUS. Among the nine patients with complete testicular torsion, eight were correctly diagnosed using HFUS, while one was only diagnosed as having an abnormal testis. In the cohort of 11 patients with incomplete testicular torsion, eight were accurately identified using HFUS, whereas three were erroneously diagnosed as having complete testicular torsion. Among the 15 patients with testicular appendage torsion, 14 were correctly diagnosed using HFUS, while one was misdiagnosed as having testicular torsion. Among the nine patients with epididymitis, seven were correctly diagnosed using HFUS, one was misdiagnosed as having testicular appendage torsion, and one was misdiagnosed as normal. However, CEUS results were consistent with the final confirmed diagnoses. The diagnostic accuracy of HFUS for acute scrotal lesions was 84.8%, whereas that of CEUS was 100%. The discrepancy between the two methods was statistically significant (χ2 = 3.50; P = 0.018, P < 0.05, respectively). Conclusion CEUS has higher accuracy in evaluating acute scrotal lesions. This can prevent misjudgment of the degree of testicular torsion, prevent misdiagnosis of testicular appendage torsion and epididymitis as testicular torsion, and avoid misjudgment of abnormal testes or epididymitides as normal. This helps prevent adverse outcomes such as delayed treatment and testicular removal.https://doi.org/10.1186/s12245-025-00944-xTestisEpididymisUltrasonographyContrast agentDoppler
spellingShingle Bin Zou
Yuling Yang
Lusheng Zhang
Huabin Chen
Fuqiang Zeng
Biwei Chen
Application of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysis
International Journal of Emergency Medicine
Testis
Epididymis
Ultrasonography
Contrast agent
Doppler
title Application of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysis
title_full Application of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysis
title_fullStr Application of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysis
title_full_unstemmed Application of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysis
title_short Application of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysis
title_sort application of contrast enhanced ultrasonography in evaluating acute testicular lesions a retrospective analysis
topic Testis
Epididymis
Ultrasonography
Contrast agent
Doppler
url https://doi.org/10.1186/s12245-025-00944-x
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