Novel prognostic grayscale ultrasonographic findings in the testis from a comprehensive analysis of pediatric patients with testicular torsion

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dc.authoridDemir, Emre / 0000-0002-3834-3864
dc.authorwosidDemir, Emre / AAA-8193-2020
dc.contributor.authorAfşarlar, Çağatay Evrim
dc.contributor.authorÇakmakçı, Emin
dc.contributor.authorDemir, Emre
dc.contributor.authorGüney, Güven
dc.contributor.authorKomut, Erdal
dc.contributor.authorElizondo, Rodolfo
dc.contributor.authorKoh, Chester J.
dc.date.accessioned2021-11-01T15:02:56Z
dc.date.available2021-11-01T15:02:56Z
dc.date.issued2019
dc.departmentHitit Üniversitesi, Tıp Fakültesi, Temel Tıp Bilimleri Bölümü
dc.departmentHitit Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü
dc.departmentHitit Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü
dc.description.abstractIntroduction Although grayscale and Doppler ultrasound (US) findings of testicular torsion (TT) have previously been described in the literature, other US findings may provide more prognostic information to families. Objective The authors hypothesized that a comprehensive analysis of US findings of TT that focused on time-dependent changes would lead to additional ultrasonographic morphologic findings and clinically relevant prognostic information. Study design The authors reviewed the records of pediatric patients with acute TT from 2010 to 2017. The sizes and parenchymal characteristics of the torsed and contralateral testes on US were analyzed in relation to the time duration from the onset of scrotal pain to the time of surgery (0-6 h, 6-12 h, 12-24 h, 24-48 h, and >48 h), torsion degree, and clinical outcomes of the testes. Results Patient demographics, time intervals, and US measurements of the torsed and contralateral testes showed significant differences with respect to testicular viability (Summary Table). The mean volume ratios of torsed to contralateral testis showed significant differences between the 0-6 h and the 12-24 h time groups as well as the 6-12 h and the 12-24 h time groups (P = 0.003 and P = 0.035, respectively), as well as significant differences between the viable and non-viable testes (P = 0.005). Regarding testicular heterogeneity, two novel grayscale sonographic findings were noted: (1) multiple hypoechoic lines that were termed 'testicular fragmentation' and (2) hyperechoic patches that were termed 'testicular patching'. The presence of these two findings were significantly increased as TT time duration increased (P < 0.001), and these findings were significantly associated with testicular non-viability (P < 0.001). Torsion degree was also noted to be significantly higher in the non-viable testes (P < 0.001). Presence of hydrocele or scrotal edema also showed significant differences between the TT time groups (P < 0.001). Discussion The results of this study demonstrated ultrasonographic findings related to time dependent changes in TT and provided prognostic information regarding testicular viability. Conclusions Specific US grayscale findings in torsed testes (testicular fragmentation and testicular patching) were identified that provide prognostic information regarding time duration of testicular torsion and testicular viability. Testicular fragmentation and testicular patching significantly increased as TT time increased, with increasing risk for testicular nonviability.
dc.identifier.citationAfsarlar, C. E., Cakmakci, E., Demir, E., Guney, G., Komut, E., Elizondo, R., ... & Koh, C. J. (2019). Novel prognostic grayscale ultrasonographic findings in the testis from a comprehensive analysis of pediatric patients with testicular torsion. Journal of pediatric urology, 15(5), 480-e1.
dc.identifier.doi10.1016/j.jpurol.2019.08.002
dc.identifier.issn1477-5131
dc.identifier.issn1873-4898
dc.identifier.issue5en_US
dc.identifier.pmid31495779
dc.identifier.scopus2-s2.0-85071683643
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1016/j.jpurol.2019.08.002
dc.identifier.urihttps://hdl.handle.net/11491/6865
dc.identifier.volume15en_US
dc.identifier.wosWOS:000498927800017
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorAfşarlar, Çağatay Evrim
dc.institutionauthorDemir, Emre
dc.institutionauthorGüney, Güven
dc.institutionauthorKomut, Erdal
dc.language.isoen
dc.publisherElsevier Sci Ltd
dc.relation.ispartofJournal Of Pediatric Urology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectTesticular Torsionen_US
dc.subjectTestisen_US
dc.subjectTesticular Viabilityen_US
dc.subjectChildrenen_US
dc.subjectUltrasounden_US
dc.titleNovel prognostic grayscale ultrasonographic findings in the testis from a comprehensive analysis of pediatric patients with testicular torsion
dc.typeArticle

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