Scrotal Ultrasound

What it does

Scrotal Ultrasound reads a scrotal study of both testes in grey-scale with colour and spectral Doppler. The exam answers two very different questions: a time-critical one, whether an acutely painful testis is torted, and a common oncologic one, whether a palpable or incidental lump is an intratesticular mass.

For torsion the run compares the two sides: absent or asymmetric intratesticular flow on colour and spectral Doppler, and the whirlpool sign of a twisted spermatic cord, combined into a torsion probability. For masses it detects intratesticular lesions, measures them and reports testicular microlithiasis.

Intended use

Decision support for the radiologist reading an acute or elective scrotal ultrasound, and for the emergency or urology team who need a structured answer while awaiting the formal report.

Who it is for

Radiologists and radiology residents, urologists, paediatric surgeons and paediatric urologists, and emergency physicians who manage the acute scrotum. Developers add the run to emergency radiology worklists and urology clinic software.

Accepted input

• Grey-scale images: DICOM Ultrasound Image or Multi-frame objects of each testis in transverse and longitudinal planes.
• Doppler images: colour or power Doppler of both testes and spectral Doppler of the intratesticular arteries.
• Cord images: grey-scale and colour views of the spermatic cord, used for the whirlpool sign.

Requirements

Requirement	Why
Both testes imaged with Doppler	Flow is judged by comparing the painful side with the other
Colour or spectral Doppler of the painful side	Absent or reduced flow is the main torsion sign
Spermatic cord images	The whirlpool sign is seen along the cord
SequenceOfUltrasoundRegions calibration	Mass size in millimetres

A study without Doppler of the painful side cannot answer the torsion question, and the result says so instead of giving a probability. Grey-scale images alone still support the mass section.

Optional context

Age, the painful side and the clinical question (acute scrotum, palpable lump, follow-up of microlithiasis) go in clinical_context.

The result

One JSON result in two sections with findings and measurements per side, and the frames each finding rests on.

Section	Content
Testicular torsion	Intratesticular flow on each side (absent, reduced, asymmetric), whirlpool sign and a torsion probability
Testicular masses	Intratesticular mass detection with size and side, and testicular microlithiasis
Draft report	Opt-in (options.report): an English narrative that interprets the result for the reader (findings, impression, limitations); every number is checked against the findings

Standards

• DICOM: SR Measurement Report TID 1500 for findings and sizes; GSPS calipers; key frames of the Doppler comparison; Encapsulated PDF.
• Terminology: SNOMED CT for findings, anatomy and laterality.

Reading notes

The torsion probability rests on the side-to-side Doppler comparison and the cord appearance, both shown in the result. A mass is reported with its side and the images that show it.

Related models

• us/abdomen reads appendicitis and intussusception in the paediatric acute abdomen.
• us/prostate reads prostate studies.