Clinical and ultrasonographic findings associated with testicular infiltration in pediatric patients with leukemia.

BACKGROUND: Testicular infiltration is infrequent in pediatric patients with leukemia and can be confused with other testicular conditions. OBJECTIVE: To analyze the presence of clinical and radiological features suggestive of testicular disease and its histological association with leukemia infiltration. METHOD: Retrospective and analytical observational study that included patients with diagnosis of leukemia who underwent biopsy for suspected testicular infiltration. The relationship with the variables analyzed were diagnosis, reason for taking the biopsy, ultrasound findings, stage of treatment, induration, increased volume and pain, with testicular infiltration. RESULTS: Eighteen patients were included; 11 of them with microlithiasis, of which one 1 reported infiltration (odds ratio: 0.075; p = 0.026), no association was found between ultrasound findings and the presence of infiltration. Clinical findings were significantly associated with positive biopsies. CONCLUSIONS: No risk association was found with the ultrasound findings such as microlithiasis and hypoechoic imaging. The clinically evident testicular disease (testicular enlargement and testicular induration) has a significant statistic association with the presence of leukemia infiltration.

ANTECEDENTES: La infiltración testicular en pacientes pediátricos con leucemia es infrecuente y puede ser confundida con otros padecimientos testiculares. OBJETIVO: Analizar la presencia de características clínicas y radiológicas sugestivas de enfermedad testicular y su asociación histológica con infiltración por leucemia. MÉTODO: Estudio observacional retrospectivo y analítico que incluyó a los pacientes con diagnóstico de leucemia sometidos a biopsia por sospecha de infiltración testicular. Se analizó la relación con las variables diagnóstico de base, motivo de toma de biopsia, hallazgos ultrasonográficos, etapa del tratamiento, induración, aumento de volumen y dolor, con infiltración a testículo. RESULTADOS: Se incluyeron 18 pacientes; de ellos, 11 con microlitiasis, de los cuales solo uno reportado con infiltración (odds ratio: 0.075; p = 0.026). No se encontró una asociación entre los hallazgos ultrasonográficos y la presencia de infiltración. Los hallazgos clínicos se asociaron significativamente con biopsias positivas. CONCLUSIONES: No se encontró una asociación de riesgo con los hallazgos por ultrasonido, como microlitiasis e imágenes hipoecogénicas. La enfermedad testicular clínicamente evidente (incremento de volumen e induración testicular) tiene una asociación estadísticamente significativa con la presencia de infiltración por leucemia.

Ultrassonografia Doppler aplicada ao diagnóstico de distúrbios testiculares em garanhões / Doppler ultrasonography applied to the diagnosis of testicular disorders in stallions / Ultrasonografía Doppler aplicada al diagnóstico de disturbios testiculares en garañones

As injúrias vasculares afetam diretamente a produção e a qualidade das células espermáticas, portanto, o diagnóstico rápido dessas alterações é de extrema importância para evitar danos irreversíveis à reprodução. Desse modo, a ultrassonografia Doppler têm se mostrado um método eficaz no diagnóstico precoce de afecções reprodutivas relacionadas com distúrbios na perfusão sanguínea testicular. Além disso, possibilita o acompanhamento de tratamentos em curso, a fim de melhorar resultados terapêuticos e proporcionar melhor previsão de fertilidade aos garanhões. Em homens, já é um método empregado para diagnosticar distúrbios de fertilidade, entretanto, na veterinária os relatos ainda são escassos e o uso por andrologistas de equinos para este fim, é esporádico. O objetivo dessa revisão é apresentar os princípios da ultrassonografia Doppler e os benefícios para a andrologia de equinos, afim de ampliar o conhecimento a respeito da técnica e facilitar o diagnóstico de afecções durante exames reprodutivos de garanhões.(AU)

Vascular disturbance directly affects sperm production and quality, so the rapid diagnosis of these changes is extremely important to avoid irreversible damage to reproduction activity. Thereby, Doppler ultrasonography has been shown to be an effective method in the early diagnosis of reproductive disorders related to testicular blood perfusion. In addition, it's possible to monitor treatments in progress for the purpose of to improve therapeutic results and provide better prediction of fertility for stallions. In men, it is already a method used to diagnose fertility disorders, however, in the veterinarian routine the reports are still scarce and the use by equine andrologists for this purpose is sporadic. Thus, the aim of this review is to present the principles of Doppler ultrasonography and its benefits for the equine andrology, in order to expand knowledge about the technique and facilitate the diagnosis of diseases during reproductive examinations of stallions.(AU)

Las afecciones vasculares afectan directamente la producción y la calidad de las células espermáticas, por lo tanto, el diagnóstico temprano de estas alteraciones es de extrema importancia para evitar daños irreversibles en la reproducción. En este sentido, la ultrasonografía Doppler ha sido empleada como un método eficaz en el diagnóstico precoz de afecciones reproductivas relacionadas con disturbios en la perfusión sanguínea testícular. Además, este método posibilita el acompañamiento de tratamientos en curso, con el fin de mejorar resultados terapéuticos y obtener una predicción de la fertilidad de los garañones. En hombres, ya es um método empleado para el diagnóstico de disturbiosde la fertilidad, mientras, en veterinaria los relatos aún son escasos y el uso por andrólogos en el campo equino para este fin, es esporádico. El objetivo de esta revisión es presentar los principios de la ultrasonografía Doppler y las ventajas para la andrología equina, con la finalidad de ampliar los conocimientos sobre esta técnica y facilitar el diagnóstico de afecciones durante los examenes reproductivos de los garañones.(AU)

Polyorquidism: case report comparing ultrasonography and magnetic resonance imaging / Poliorquidismo: relato de caso comparando a ultrassonografia e a ressonância magnética

Abstract Introduction: polyorchidism is an unusual pathology, about 200 cases in the world literature. Case report: we reported a case of polyorchidism in a 16-year-old male patient diagnosed by ultrasound and confirmed by magnetic resonance imaging. Discussion: most of the cases presented, there is a supernumerary testis, but there are reports on more than three, up to five testicles with supranumerical gonads on both sides of the scrotum. The diagnosis is usually performed in late puberty, incidentally, with a painless scrotal mass or at the emergency room, presenting a testicular torsion of the whole hemiscrotum or supernumerary testisalone, and the differential diagnosis should be made with epididymal cyst and spermatocele, besides other extra-testicular masses (hydroceles, varicoceles, lipomas, tumors.) and para-testicular masses (hernias, scrotal calculi). After the initial clinical evaluation, ultrasound is the first line subsidiary exam. Magnetic Resonance Imaging is very helpful, just in case the ultrasound diagnosis is uncertain. The supernumerary testishave the same Magnetic Resonance Imaging characteristics as the normal testes (intermediate signal intensity on T1- weighted images and high signal intensity on T2-weighted images).

Resumo Introdução: o poliorquidismo é uma patologia incomum, contando cerca de 200 casos na literatura mundial. Relato de caso: relatamos um caso de poliorquidismo em um paciente do sexo masculino de 16 anos, diagnosticado por ultrassom e confirmado por ressonância magnética. Discussão: na maioria dos casos apresentados, há um testículo supranumérico, mas há relatos de mais de três, até cinco testículos, com gônadas supranuméricas em ambos os lados do escroto. O diagnóstico geralmente é feito no final da puberdade, aliás, com massa escrotal indolor ou no pronto-socorro, apresentando torção de todo o hemiscroto ou somente do testículo supranumerário, e o diagnóstico diferencial deve ser feito com cisto epididimário e espermatocele, além de outros massas extratesticulares (hidroceles, varicoceles, lipomas, tumores) e massas paratesticulares (hérnias, cálculos escrotais). Após a avaliação clínica inicial, o ultrassom é a primeira linha do exame subsidiário. A ressonância magnética é muito útil se o diagnóstico por ultrassom não for certo. Os testículos supranumerários têm as mesmas características de ressonância magnética que os testículos normais (intensidade do sinal intermediário nas imagens ponderadas em T1 e alta intensidade do sinal nas imagens ponderadas em T2).

Ultrassonografia Doppler aplicada ao diagnóstico de distúrbios testiculares em garanhões / Doppler ultrasonography applied to the diagnosis of testicular disorders in stallions / Ultrasonografía Doppler aplicada al diagnóstico de disturbios testiculares en garañones

As injúrias vasculares afetam diretamente a produção e a qualidade das células espermáticas, portanto, o diagnóstico rápido dessas alterações é de extrema importância para evitar danos irreversíveis à reprodução. Desse modo, a ultrassonografia Doppler têm se mostrado um método eficaz no diagnóstico precoce de afecções reprodutivas relacionadas com distúrbios na perfusão sanguínea testicular. Além disso, possibilita o acompanhamento de tratamentos em curso, a fim de melhorar resultados terapêuticos e proporcionar melhor previsão de fertilidade aos garanhões. Em homens, já é um método empregado para diagnosticar distúrbios de fertilidade, entretanto, na veterinária os relatos ainda são escassos e o uso por andrologistas de equinos para este fim, é esporádico. O objetivo dessa revisão é apresentar os princípios da ultrassonografia Doppler e os benefícios para a andrologia de equinos, afim de ampliar o conhecimento a respeito da técnica e facilitar o diagnóstico de afecções durante exames reprodutivos de garanhões.

Vascular disturbance directly affects sperm production and quality, so the rapid diagnosis of these changes is extremely important to avoid irreversible damage to reproduction activity. Thereby, Doppler ultrasonography has been shown to be an effective method in the early diagnosis of reproductive disorders related to testicular blood perfusion. In addition, it's possible to monitor treatments in progress for the purpose of to improve therapeutic results and provide better prediction of fertility for stallions. In men, it is already a method used to diagnose fertility disorders, however, in the veterinarian routine the reports are still scarce and the use by equine andrologists for this purpose is sporadic. Thus, the aim of this review is to present the principles of Doppler ultrasonography and its benefits for the equine andrology, in order to expand knowledge about the technique and facilitate the diagnosis of diseases during reproductive examinations of stallions.

Las afecciones vasculares afectan directamente la producción y la calidad de las células espermáticas, por lo tanto, el diagnóstico temprano de estas alteraciones es de extrema importancia para evitar daños irreversibles en la reproducción. En este sentido, la ultrasonografía Doppler ha sido empleada como un método eficaz en el diagnóstico precoz de afecciones reproductivas relacionadas con disturbios en la perfusión sanguínea testícular. Además, este método posibilita el acompañamiento de tratamientos en curso, con el fin de mejorar resultados terapéuticos y obtener una predicción de la fertilidad de los garañones. En hombres, ya es um método empleado para el diagnóstico de disturbiosde la fertilidad, mientras, en veterinaria los relatos aún son escasos y el uso por andrólogos en el campo equino para este fin, es esporádico. El objetivo de esta revisión es presentar los principios de la ultrasonografía Doppler y las ventajas para la andrología equina, con la finalidad de ampliar los conocimientos sobre esta técnica y facilitar el diagnóstico de afecciones durante los examenes reproductivos de los garañones.

The prevalence of ultrasonographic abnormalities and histopathologic lesions is high in testes of yearling tropical hair rams.

Ultrasonography is commonly used to examine testes as part of a breeding soundness examination in sheep, especially, in cases of infertility or when gross testicular abnormalities are present. A descriptive, prospective, prevalence study was conducted to characterize the ultrasonographic, histopathologic, and spermatozoal morphology abnormalities present in a group of yearling tropic hair rams on the island of St. Kitts. Hyperechoic and shadowing abnormalities increased over a 6 month study period. Hyperechoic abnormalities were present in one or both testes in 89% (25/28) of yearling rams and 71% (40/56) of testes at castration. Shadowing abnormalities were present in one or both testes in 46% (13/28) of rams and 34% (19/56) of testes at castration. Shadowing was present more with moderate and severe hyperechoic abnormalities, with few testes in the mild category having any shadowing. As hyperechoic and shadowing abnormalities increased in severity, so did the severity of microscopic lesions including increased interstitial cellularity/fibrosis, interstitial mineralization, seminiferous tubules mineralization (hyperechoic only), and chronic lymphoplasmacytic orchitis. There were no spermatozoal morphologic abnormalities other than an increase in distal cytoplasmic droplets. The study findings detail a pathologic event in this group of yearling rams that has an unknown etiology. Potential causes may include scrotal insulation, trauma, infectious causes, immunity alterations, nutritional imbalances, and ingestion of a toxin. Further studies are required to elucidate the causative agent.

Application of ultrasound technology in the study of ischemic postconditioning to protect testes from ischemia-reperfusion injury.

This study was designed to investigate the application of ultrasound technology in the study of ischemic postconditioning to protect testes from ischemia-reperfusion injury. Seventy-two big white rabbits were divided into mild ischemic groups (Group A: A0, A1, A2, A3), moderate ischemic groups (Group B: B0, B1, B2, B3) under ultrasound monitor, and control group (N = 8). Groups A0 and B0 received direct perfusion, while the other groups received a different short time filling/stopped filling treatment (15 s/15 s, 30 s/30 s, or 45 s/45 s) three times before complete perfusion. Each group received contrast-enhanced ultrasound before complete filling. At 3 days after perfusion, the testicular tissue was removed for biopsy. The parameters of testicular contrast in pre-reperfusion groups A and B differed significantly from those of their corresponding control groups (P < 0.05). The changes in testis-related pathological indicators in groups A1 and A2 were more significant than those of group A0 (P < 0.05), and changes in group B2 were more obvious than those of group B0 (P < 0.05). There were no statistically significant differences in the comparison of other indicators between the corresponding groups (P > 0.05). Ultrasound technology can help build different degree models of ischemic testes and predict the protective effect of post-ischemic treatment.

Clinical importance and prevalence of testicular microlithiasis in pediatric patients.

PURPOSE: To evaluate the prevalence of testicular microlithiasis among pediatric patients with inguinoscrotal affections. METHODS: Between January 2005 and January 2010, we evaluated, prospectively 1504 children ranging from 1 to 15 years with inguinoscrotal affections with a high-frequency ultrasound system, which employs a 10-MHz transducer. RESULTS: Testicular microlithiasis was identified in 20 testes of eleven children (0.71% of 1504 patients evaluated), through an ultrasound scan. Testicular microlithiasis was found in 5 children with cryptorchidism (3.93% of 127 patients), 4 children with retractile testes (14.8% of 27 patients), 1 child with a hypotrophic testis (100% of 1 patient), and 1 child with inguinal hernia (0.07% of 1349 patients). The children with testicular microlithiasis were submitted to annual physical examinations and ultrasound evaluations. CONCLUSIONS: Testicular microlithiasis was a rare condition and occurred in 0.7% of the subjects studied. The association with cryptorchidism, retractile and hypotrophic testis was significant.

Scrotal emergencies.

This review describes the clinical, grey-scale and colour Doppler US findings of different conditions that may be the cause of an acute scrotum. The US appearances of testicular torsion, torsion of the appendix testis, epididymoorchitis, incarcerated hernia and idiopathic scrotal oedema are described. Some of the major studies regarding the sensitivity and specificity of US in the diagnosis of these diseases are reviewed. Grey-scale and colour Doppler US demonstrate high accuracy in the aetiological diagnosis of an acute scrotum and can differentiate between diseases that require immediate surgical intervention and those that can be treated conservatively.

Doppler sonographic findings in testicular microlithiasis.

OBJECTIVE: The aim of this prospective study was to compare the resistive index (RI) values, which is a parameter of testicular parenchymal perfusion, in testicular microlithiasis (TM) cases and normal cases. MATERIALS AND METHODS: 2179 volunteers, all healthy men (17-42 years of age) from the Annual Army Reserve Officer Training Corps training camp were included in the study. A screening scrotal ultrasound was performed and all men diagnosed with TM underwent a scrotal Doppler ultrasonography scan (US). US examinations were performed for subjects with TM and without TM as a control group and RI was determined. RESULTS: 53 men with TM were identified in the 2179 US. Spectral Doppler examination was applied to 50 randomly selected cases (100 testicles) without TM and 92 testicles with TM, 39 cases (78 testicles) with bilateral and 14 cases with unilateral involvement. However, 48 normal testicles (17 bilateral and 14 unilateral) and 47 testicles with TM (15 bilateral and 17 unilateral, 10 of which were cases with bilateral TM) where flow from the centripetal artery could be obtained and analyzed were included in the statistical analysis for resistive indices. There was no significant difference regarding the RI and spectral examinations between subjects with and without TM. An interesting finding was the twinkling artifact observed in three cases. CONCLUSION: Microliths did not alter the RI values and thus had no influence on testicular perfusion on Doppler US examination.