sodium-pertechnetate-tc-99m and Genital-Diseases--Male

Topics: Acute Disease; Adult; Age Factors; Analgesics; Epididymitis; Genital Diseases, Male; Gonorrhea; Humans; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Technetium; Testicular Neoplasms; Testis; Tetracycline; Trachoma; Ultrasonography

Topics: Adult; Cellulitis; Diagnosis, Differential; Genital Diseases, Male; Humans; Infarction; Male; Radionuclide Imaging; Radiopharmaceuticals; Scrotum; Self Mutilation; Sodium Pertechnetate Tc 99m; Testis

The aim of this prospective study was to compare the effectiveness of colour Doppler ultrasound and testicular scintigraphy in the differential diagnosis of acute scrotum. Ten patients were investigated by clinical examination initially and by both techniques afterwards. Scintigraphy was performed in a blind fashion. According to the findings, 3 patients were categorized as acute ischaemia and 7 as inflammation. The 3 patients diagnosed as ischaemia underwent surgical exploration. Both imaging techniques predicted ischaemia (100%). In the inflammation group conservative therapy and follow-up were chosen. Ultrasonography alone established the correct diagnosis in 7/7, whereas scintigraphy in 5/7 of the patients.

Topics: Acute Disease; Child; Child, Preschool; Genital Diseases, Male; Humans; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Testis; Ultrasonography, Doppler, Color

Topics: Diagnosis, Differential; Genital Diseases, Male; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Aggregated Albumin; Varicocele

The efficacy and merit of testicular imaging, utilizing Tc-99m pertechnetate, were studied prospectively in a group of patients who presented with acute onset of scrotal pain. Consecutive admissions were studied. All were managed according to the likelihood of the problem being testicular torsion, which was determined from the clinical history, physical examination and the routine laboratory data. The final diagnostic outcome, whether by surgical exploration or clinical progress with conservative treatment, is collated with the preoperative scintigraphic interpretations, made with respect to predefined criteria. Analysis of the pretreatment images obtained in 57 patients shows that the radionuclide study is highly reliable in cases of testicular torsion and epididymo-orchitis. It appears to be much less dependable, however, in the other acute scrotal conditions. Torsions that are intermittent in nature or corrected manually apparently can have variable presentations. Certain difficulties and potential pitfalls encountered in interpreting the scintigraphic studies are discussed.

Topics: Abscess; Acute Disease; Adolescent; Adult; Aged; Child; Epididymitis; Genital Diseases, Male; Humans; Male; Middle Aged; Orchitis; Pain; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Testicular Hydrocele

Testicular scanning with technetium-99m sodium pertechnetate was performed on 152 patients with a variety of intrascrotal lesions. Scrotal images were obtained serially in the perfusion, tissue phase, illustrating the features of each phase in various clinical conditions. The relationship of scrotal imaging to the overall clinical presentation and evaluation of these patients is emphasized in testicular torsion of the testicular appendix, epididymitis, abscess, trauma, tumor, spermatocele, and varicocele. Technical problems of the scanning are also discussed.. Testicular scanning with technetium-99m sodium pertechnetate was performed on 152 patients with various intrascrotal lesions. Prior to scanning, the patients were given an oral dose of 200 mg KD104 to control thyroid gland's exposure to radiation. Scrotal images were obtained 16 times with 2 seconds' interval in the perfusion phase and twice with 5 minutes' interval in the tissue phase. The rate of correct diagnosis by scrotal images were 100% for testicular torsion and acute epididymitis, significantly high for scrotal abscess and varicocele, 40-50% for testicular tumor, and low in the cases of hydrocele, testicular trauma and spermatocele. In testicular torsion, a rounded cold area and a halo of dartos perfusion were observed. Scrotal imaging proved to be useful for post-operative diagnosis of testicular vascularity also. In "missed" testicular torsion, scrotal scan showed a "halo sign" in the tissue phase due to intensified vascularity in the dartos, and a "nubbin sign" in the perfusion phase due to the increased perfusion of spermatic cord vessels. In acute epididymitis scrotal scan showed increased activity spanning spermatic cord vessels and scrotum in the perfusion phase, and increased curvilinear activity in the tissue phase. In scrotal abscess increased perfusion from spermatic cord vessels and pudendal artery were observed in the perfusion phase. In the tissue phase increased dartos perfusion and a cold area due to the formation of abscess was observed. In varicocele, increased perfusion in the location which corresponded to the pampiniform plexus of the vein was observed in venous phase.

Topics: Adult; Epididymitis; Genital Diseases, Male; Humans; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Testicular Neoplasms; Testis