Role of Colour Doppler Imaging and Sonographic Appearances in Diagnosis of Scrotal Disorder

Abstract

Background: Scrotal disorders, including inflammatory, vascular, neoplastic, and traumatic conditions, can significantly affect male reproductive health, presenting with symptoms such as pain, swelling, or masses. Accurate diagnosis is essential, and imaging techniques like ultrasonography (US) and Color Doppler Imaging (CDI) have become critical tools due to their non-invasive nature and high sensitivity. Grayscale US provides detailed anatomical views, especially for testicular tumors and hydroceles, while CDI assesses blood flow, aiding in the diagnosis of conditions like testicular torsion, epididymal-orchitis, and varicoceles. CDI also plays a vital role in evaluating scrotal trauma and testicular viability. Aim of the study: This study aims to explore the effectiveness of CDI in conjunction with grayscale ultrasonography in diagnosing various scrotal disorders. Methods: This prospective observational study was conducted over 12 months at the Department of Radiology and Imaging, BSMMU, Dhaka, Bangladesh from July 2023 to August 2024 including 85 male patients with scrotal pain, swelling, or masses. Grayscale ultrasonography and Color Doppler Imaging (CDI) were used to evaluate scrotal abnormalities, vascularity, and blood flow. Ethical approval and informed consent were obtained. Based on imaging criteria, patients were assessed for hydrocele, epididymal cysts, spermatoceles, varicocele, and testicular cysts. Exclusion criteria included prior surgery, incomplete imaging, and unwillingness to participate. Data were analyzed using SPSS (version 26.0), with results recorded in a structured proforma for analysis. Results: The study on 85 Bangladeshi patients with scrotal disorders found that the majority (52.9%) were aged 20-40 years. Common symptoms include pain and swelling (35.3%), with some cases involving fever (11.8%). The most frequent conditions were hydrocele (29.4%), varicocele (16.5%), and inflammatory conditions (44.7%), mainly acute and chronic epididymitis and epididymal-orchitis. Bilateral pathology was observed in 35.3% of cases. Non-inflammatory disorders like hydrocele and varicocele were more common (60%), while inflammatory conditions, including acute epididymitis and Fournier’s gangrene, accounted for 44.7% of the cases. Conclusion: The study concludes that scrotal pathologies in Bangladeshi patients are diverse, with hydrocele, varicocele, and inflammatory conditions being the most common. CDI and sonography are practical diagnostic tools for accurately identifying these conditions and guiding appropriate treatment.