To Determine the Validity of High Resolution B-scan and Power Doppler Ultrasound in Detection of Scrotal Masses

Objectives: To determine the accuracy of high resolution grey scale(B-Scan) and Doppler ultrasound in detection of scrotal masses. Material and Methods: This is descriptive cross-sectional study, which was conducted at the Radiology Department of Hayatabad Medical Complex, Peshawar over a period of twelve months i.e. from October 2009 to October 2010. Patients referred to Radiology Department with scrotal swelling (painless or painful) were scanned with 7.5 to 11 MHz linear transducer on NEMIO 20 scanner in supine position and erect posture when needed. Gray scale ultrasound was first conducted to determine the size, location and echogenicity of the lesion. Doppler ultrasound was done to assess and document the blood flow, spectrum, and velocity of flow and indices in the testes, 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. Sample size was 112, using 100% sensitivity, 90% specificity, 86% prevalence, 95%confedence level and 6% margin of error. Sample technique was non-probability convenience sampling. Results: In this study, 112 male patients with scrotal swelling / mass (both painful and painless) had ultrasound examination. Benign masses were found in 89(79.46%) of the patients, while 23(20.54%) had a malignant testicular tumor. The study included age ranges from 1 up to 59 years. Average age was 29.48 years+ 11.36SD. Most of the masses were found unilateral 54.5% on right side. On left side it was 41.1% while 4.5% were found on both sides. Age wise distribution of biopsy results shows that majority of the malignant masses (39.1%) were found in less than 29 years of age while 3.4% patients who were above 49 years of age had benign masses. Conclusion: Gray scale ultrasound in combination with Doppler ultra sound is a good imaging technique in patients presenting with scrotal masses. Benign masses are more accurately diagnosed than tumors that require histopathology for exact tissue characterization.