1-Do the examination in the up-right position.
2-measure the diameter of the dominent vein at the inguinal canal
if it is >2.5 mm = varicocele.
then ask the patient to do valsalva maneuver
if the diameter of this vein increased by more than one 1mm = varicocele.
3-Search of varicocele any where around the testicle (Tortuous anechoic tubular structures are demonstrated adjacent to the testis).
4-check presence of intra-testicular varicocele (Tortuous anechoic tubular structures are demonstrated inside the testis).
5-Do color doppler ultrasound to differentiate the following:
-venous channels from epidermoid cyst and spermatocele.
-stop type of flow from shunt type of flow.
-grading varicocele.
grade 1 : static
grade 2 :intermitent
grade 3 :continuous.
6- Then report on the testicles,epededymi and any abnormality could be detected such as hydrocele or abnormal skin folds thickening.
Showing posts with label reporting of varicocele. Show all posts
Showing posts with label reporting of varicocele. Show all posts
Monday, July 19, 2010
reporting of varicocele
Ultrasonographic findings in varicoceles include the following:
1-Tortuous anechoic tubular structures are demonstrated adjacent to the testis.
2-With the patient in an upright position, the diameter of the dominant vein at the inguinal canal measures more than 2.5 mm and is associated with an increase in diameter of at least 1 mm during a Valsalva maneuver.
3-Varicoceles can be small to very large, with some enlarged vessels as large as 8 mm in diameter.
4-Varicoceles can be found anywhere in the scrotum (ie, medial, lateral, anterior, posterior, or inferior to the testis).
5-Color Doppler ultrasonographic imaging can be helpful in differentiating venous channels from epidermoid cysts or spermatoceles when doubt exists.
6-Bidirectional Doppler ultrasonography performed with the patient in the upright position with quiet respiration shows a shunt type of flow in 86% of patients in whom insufficient distal valves allow spontaneous and continuous reflux from the ISV into the cremasteric vein and the vein of the vas deferens.
7-Bidirectional Doppler ultrasonography performed with the patient in the upright position with quiet respiration shows a stop type of flow in 14% patients in whom intact valves allow only sporadic reflux from the spermatic vein into the pampiniform plexus with a Valsalva maneuver.
8-Doppler ultrasonography can be used to grade venous reflux as static (grade I), intermittent (grade II), or continuous (grade III) .
9-Effective sclerotherapy is indicated when venous dilatation resolves and the overall diameter of the veins decreases.
10-Intratesticular varicoceles may appear as a vague hypoechoic area in the testis. They appear tubular or oval shaped and usually lie near the mediastinum testis.
http://emedicine.medscape.com/article/382288-imaging
1-Tortuous anechoic tubular structures are demonstrated adjacent to the testis.
2-With the patient in an upright position, the diameter of the dominant vein at the inguinal canal measures more than 2.5 mm and is associated with an increase in diameter of at least 1 mm during a Valsalva maneuver.
3-Varicoceles can be small to very large, with some enlarged vessels as large as 8 mm in diameter.
4-Varicoceles can be found anywhere in the scrotum (ie, medial, lateral, anterior, posterior, or inferior to the testis).
5-Color Doppler ultrasonographic imaging can be helpful in differentiating venous channels from epidermoid cysts or spermatoceles when doubt exists.
6-Bidirectional Doppler ultrasonography performed with the patient in the upright position with quiet respiration shows a shunt type of flow in 86% of patients in whom insufficient distal valves allow spontaneous and continuous reflux from the ISV into the cremasteric vein and the vein of the vas deferens.
7-Bidirectional Doppler ultrasonography performed with the patient in the upright position with quiet respiration shows a stop type of flow in 14% patients in whom intact valves allow only sporadic reflux from the spermatic vein into the pampiniform plexus with a Valsalva maneuver.
8-Doppler ultrasonography can be used to grade venous reflux as static (grade I), intermittent (grade II), or continuous (grade III) .
9-Effective sclerotherapy is indicated when venous dilatation resolves and the overall diameter of the veins decreases.
10-Intratesticular varicoceles may appear as a vague hypoechoic area in the testis. They appear tubular or oval shaped and usually lie near the mediastinum testis.
http://emedicine.medscape.com/article/382288-imaging
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