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Comparison of conventional Doppler imaging techniques and superb microvascular imaging in determination of vascularization in undescended testes

Fatih Ates
Fatih Ates
, 
Mesut Sivri
Mesut Sivri
, 
Mehmet Sedat Durmaz
Mehmet Sedat Durmaz
, 
Tamer Sekmenli
Tamer Sekmenli
, 
Metin Gunduz
Metin Gunduz
 y 
Ilhan Ciftci
Ilhan Ciftci
   | 11 may 2023
Journal of Ultrasonography's Cover Image
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Article Category: Research paper
Publicado en línea: 11 may 2023
Páginas: e66 - e72
Recibido: 21 dic 2021
Aceptado: 31 ene 2023
DOI: https://doi.org/10.15557/jou.2023.0013
Palabras clave
© 2023 Fatih Ates et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

Right testis in the medial section of inguinal channel was demonstrated by grayscale ultrasonography and testicular volume was calculated (A, B). No spot color encoding (SCE) and linear flow color encoding (LFCE) counts were observed in CD (C). In PD (D) and cSMI mode (E) one LFCE was observed. In mSMI; two LFCE and three SCE were observed, as shown with arrows (F, G). (CD: color Doppler; PD: power Doppler; cSMI: color superb mıcrovascular imaging; mSMI: monochrome superb microvascular imaging; SCE: spot color encoding; LFCE: linear flow color encoding)
Right testis in the medial section of inguinal channel was demonstrated by grayscale ultrasonography and testicular volume was calculated (A, B). No spot color encoding (SCE) and linear flow color encoding (LFCE) counts were observed in CD (C). In PD (D) and cSMI mode (E) one LFCE was observed. In mSMI; two LFCE and three SCE were observed, as shown with arrows (F, G). (CD: color Doppler; PD: power Doppler; cSMI: color superb mıcrovascular imaging; mSMI: monochrome superb microvascular imaging; SCE: spot color encoding; LFCE: linear flow color encoding)

Testes of operated 44 patients (OUT, testes having contralateral inguinal canal distal placement under follow-up and contralateral normally located testes) in terms of age, volume, and SCE-LFCE numerical values. (SCE: spot color encoding, LFCE: linear flow color encoding, CD: color Doppler, PD: power Doppler)

Operated UDT (44) Inguinal canal distal under follow-up (7) Normal contralateral testicle (27)
Age (months) 74.06 ± 56.17 54.57 ± 45.06 60.2 ± 42.3
Volume 1.31 ± 3.12 0.60 ± 0.14 0.74 ± 0.28
CD -SCE 0.50 ± 1.62 0.001 ± 0.001 0.70 ± 2.27
-LFCE 0.16 ± 0.57 0.001 ± 0.001 0.22 ± 0.97
PD -SCE 1.09 ± 2.40 0.001 ± 0.001 1.33 ± 2.71
-LFCE 0.34 ± 0.80 0.14 ± 0.38 0.89 ± 1.55
cSMI -SCE 1.68 ± 4.25 0.001±0.001 3.25 ± 8.99
-LFCE 0.47 ± 1.13 0.001±0.001 1.11 ± 2.21
mSMI -SCE 6 ± 6.58 2.14 ± 1.46 7.78 ± 14.08
-LFCE 1.61 ± 1.82 0.43 ± 0.53 3.26 ± 3.62

Age, volume, and CDIT-SMI numerical values of testes according to the groups. (SCE: spot color encoding, LFCE: linear flow color encoding, CD: color Doppler, PD: power Doppler)

Group A Group B Group C
Age (months) 74.06 ± 56.17 59.95 ± 40.93 83.48 ± 76.80
Volume 1.31 ± 3.12 0.56 ± 0.31 2.74 ± 5.15
CD -SCE 0.50 ± 1.62 0.16 ± 0.48 1.62 ± 2.71
-LFCE 0.16 ± 0.57 0.04 ± 0.20 0.24 ± 0.61
PD - SCE 1.09 ± 2.40 0.54 ± 0.98 5.43 ± 7.84
-LFCE 0.34 ± 0.80 0.25 ± 0.74 0.77 ± 1.01
cSMI -SCE 1.68 ± 4.25 1.0 ± 2.21 5.92 ± 10.33
-LFCE 0.47 ± 1.13 0.5 ± 0.98 0.68 ± 1.20
mSMI -SCE 6 ± 6.58 3.54 ± 2.90 10.68 ± 14.28
-LFCE 1.61 ± 1.82 1.75 ± 1.45 2.27 ± 2.22

UDT testicular volumes and mSMI numerical values were compared. When volume values increased, mSMI SCE and LFCE values were significantly increasing (correlation coefficient form SMI SCE: 0.312; correlation coefficient form SMI LFCE: 0.365). No significance was observed between mSMI numerical values of the post-operative period and age at operation

mSMI Post-operative period Age at operation Volume
-SCE p = 0.914 p = 0.728 p <0.001
-LFCE p = 0.006 p = 0.698 p <0.001

Age, volume, and Doppler numerical values of all undescended testes (newly diagnosed and follow-up undescended testes) (SCE: spot color encoding, LFCE: linear flow color encoding, CD: color Doppler, PD: power Doppler)

Inguinal canal proximal (n = 6) Inguinal canal medium (n = 18) Inguinal canal distal (n = 15) Scrotal (n = 98)
Age (months) 39.00 ± 22.36 65.16 ± 40.77 60.40 ± 42.64 78.03 ± 68.35
Volume 0.27 ± 0.08 0.56 ± 0.26 0.57 ± 0.27 2.74 ± 5.15
CD -SCE 0.001 ± 0.001 0.22 ± 0.55 0.001 ± 0.001 1.10 ± 2.38
-LFCE 0.001 ± 0.001 0.05 ± 0.24 0.001 ± 0.001 0.21 ± 0.68
PD - SCE 0.001 ± 0.001 0.61 ± 1.09 0.20 ± 0.41 3.33 ± 6.13
-LFCE 0.001 ± 0.001 0.39 ± 0.85 0.001 ± 0.001 0.68 ± 1.01
cSMI -SCE 0.66 ± 1.63 0.94 ± 2.41 0.33 ± 0.72 4.14 ± 8.78
-LFCE 0.50 ± 1.22 0.33 ± 0.68 0.20 ± 0.77 0.73 ± 1.45
mSMI -SCE 2.66 ± 2.34 4.11 ± 2.95 3.80 ± 5.29 8.62 ± 12.45
-LFCE 1.16 ± 1.47 1.66 ± 1.61 0.93 ± 0.96 2.31 ± 2.50

Testes included in the study according to localization, operation history, and grouping of testes. UDT was classified as inguinal canal proximal, inguinal canal medium, and inguinal canal distal. Control group including contralateral normally located of OUTs, follow-up UDT and control group of normally located bilateral testes

Testicular localization Group Total n (%)
OUT Scrotal A n = 44 (24.31%)
Newly diagnosed UDT (n = 24), (13.26%) Inguinal canal proximal (n = 6) (15.39%) B n = 39 (21.55%)
Follow-up UDT (n = 15), (8.29%) Inguinal canal medium (n = 18) (46.15%)
Inguinal canal distal (n = 15) (38.46%)
Contralateral normally located of OUT (n = 27), (27.56%) Scrotal C n = 98 (54.14%)
Contralateral normally located of UDT ((n = 5), (5.1%)
Bilaterally normal testes (n = 66), (67.34%)
Total (n = 173), (100%) Scrotal or inguinal A + B + C n = 181 (100%)
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