Gray scale and doppler ultra-sound in the diagnosis of painless scrotal masses

Document Type





Objective: To determine the role of gray scale and Doppler Ultrasound in the diagnosis of painless scrotal masses.
Methodology: It was a descriptive study conducted at Department of radiology, Dow University of Health Science (DUHS) and Civil Hospital Karachi (CHK) from June 2006 to June 2007. Adult patients with painless scrotal mass referred for ultrasound examination, were included in the study. All subjects were scanned with 11 MHz linear transducer on NEMIO 17 scanner in supine position and erect posture as and when needed. Gray scale ultrasound was first conducted to determine the size, location and echogenecity of the lesion. Doppler ultrasound was done to assess and document the blood flow, spectrum, and velocity of flow and indices in the epididymis, as well as in the lesion. Accuracy of Doppler scan was determined against histopathology of the respected specimen in case of tumors and against surgical findings in the benign lesions.
Results: The average age of the patients was 38.51 ± 9.4 years. The most common scrotal mass was hydrocele (n=24, 34.29%) followed by varicocele (n=13, 18.57%), testicular tumors (n= 12, 17.14%), spermatocele (n = 11, 15.71%) and epididymal cyst (n=10, 14.29%). Out of 12 testicular tumors, there were 05 cases of seminoma (41.7%), 02 of cases of embryonal cell carcinomas (16.7%), two epidermoid cysts (16.7%) and 01(8.3%)each of teratoma, choriocarcinoma with metastasis and testicular lymphoma Sensitivity and positive predictive value of the ultrasound were 66.7% and 100%.
Conclusion: Gray scale ultrasound in combination with Doppler ultra sound is a good imaging technique in patients presenting with painless scrotal masses. Benign masses are more accurately diagnosed than tumors that require histopathology for exact tissue characterization.

Publication (Name of Journal)

Pakistan Journal of Medical Sciences