Torsed appendix testis: gray scale and color Doppler sonographic findings compared with normal appendix testis.

OBJECTIVE: The purpose of this study was to compare the size, shape, echogenicity, and blood flow of the appendix testis on sonography in control subjects and in patients with a torsed appendix testis and to evaluate the usefulness as well as the limitations of these criteria.

METHODS: This was a retrospective analysis of 11 lesions with torsed appendix testes and 15 normal appendix testes in 12 children. The following gray scale and color Doppler sonographic features were analyzed: size, shape, echogenicity, and blood flow of the appendix testis.

RESULTS: The size of the appendix testis was larger in patients with a torsed appendix testis than in the control subjects (P < .05). A spherical shape of the appendix testis was more common in patients with a torsed appendix testis (P < .05). There was no blood flow within both the torsed and normal appendix testes. However, the frequency of increased periappendiceal blood flow was higher in patients with a torsed appendix testis (P < .05). There was no significant difference in the echogenicity between the torsed and normal appendix testes.

CONCLUSIONS: Gray scale and color Doppler sonography may be helpful in the diagnosis of torsion of the appendix testis. A size of 5 mm or larger, spherical shape, and increased periappendiceal blood flow are indicative of a torsed appendix testis.