Scrotal scintigraphy is a method of functional visualization of the testicles after intravenous administration of isotopes, the radiation of which is recorded by a scintillation chamber. The study allows us to assess the structure of the testicles, their size, shape, position and functional state. It is used in the diagnosis of inflammatory processes, developmental abnormalities, vascular pathologies, neoplasms and traumatic injuries. It is performed on an outpatient basis after intravenous administration of a radiopharmaceutical.
The basis of scrotal scintigraphy is the absorption of radioisotopes by tissues. Before passing the examination, the patient is injected intravenously with a radionuclide drug. After that, the dynamic recording of changes in the scrotum, in particular in the testicles, begins. This initial stage lasts no more than twenty minutes.
It is important that the patient remains calm and patient during the study itself. The patient should lie on his back all the time and not change the position of the body without the consent of the doctor. After a while, the doctor may ask the patient to get up and stand for a while until the gamma camera captures all the necessary data.
To conduct a study of the scrotum and testicles, a unique drug pertechnetat 99mTs is used. The total time of the entire examination begins from the moment of introduction of the radionuclide. The duration of the examination itself may be different, since it all depends on the complexity of a particular case and the presence of certain diseases, but, as a rule, does not exceed forty minutes.
As practice shows, a lot of problems in terms of diagnosis are caused by epididymitis and testicular torsion, because their symptoms are similar, and treatment methods differ radically. Accordingly, the doctor is doubly responsible for the examination, because the effectiveness of treatment and the patient’s state of health will directly depend on how correctly he deciphers the diagnostic results.
In such situations, pre-blockade of the capture of the drug by the thyroid gland is performed, for which potassium perchlorate is used (introduced at the rate of 6 mt / kg).
The examination process itself is usually divided into two stages:
- static stage (tissue phase);
- angiographic stage (vascular phase).
The first stage of the examination is characterized by obtaining an image already 3-5 minutes after administration of the drug with radionuclide components. In some cases, a convergent drug is added to improve the results, thanks to which “cold” and “hot” zones in the scrotum become visible in the picture.
Accordingly, at the angiographic stage, the level of vascularization and symmetry of the testicles is studied, which can be reduced, increased and normal. Thus, after the received scintigraphy data, the doctor gets the opportunity to refute or confirm certain assumptions. For example, low activity of the vascular system of the testicle may indicate normal blood flow and the condition of the scrotum.
The main feature of scrotal scintigraphy is that the affected tissues absorb special radionuclide preparations. Due to this property, the affected areas are clearly visible in the picture in the future, which allows doctors to get maximum information about the pathology.
Indications
The scrotum is a skin-muscle sac in which the testicles, appendages and parts of the spermatic cord are located. As medical practice shows, the most common problems associated with testicles are various diseases and pathologies.
Congenital anomalies, such as cryptorchidism, are quite common. This pathology is characterized by the absence of one or two testicles in boys at the time of birth. This situation is due to the fact that the testicles were in the inguinal canal, so they did not have time to descend. In such cases, scintigraphy of the testicles is a mandatory examination, thanks to which doctors will be able to assess the situation and explore the functionality of the newborn’s reproductive system.
In addition, there are other indications for scrotal scintigraphy:
- testicular twisting;
- male infertility;
- varicocele;
- epididymitis, orchitis and other inflammatory diseases of the testicles;
- testicular injuries;
- hypogonadism;
- testicular transplantation;
- dropsy of the testicle;
- testicular neoplasms and the like.
In the case of testicular transplantation, statistics show that out of 42 men who underwent this operation, 15 should undergo the procedure of scintigraphy. After they pass the examination, they receive a scintigram, which displays all the diagnostic results, thanks to which the attending physician assesses the situation and draws conclusions about the patient’s rehabilitation status.
According to doctors, sometimes even the slightest injury to the testicles or groin area can lead to the development of a dangerous disease. That is why it is recommended to regularly go to the doctors for examination in order to protect yourself from trouble.
Acute pain in the groin should also alert, because this is a symptom of many pathologies or diseases of the scrotum. It is especially necessary to pay attention to this in childhood. In any case, when such symptoms appear, it is necessary to contact doctors as soon as possible in order to undergo a timely examination and, if necessary, begin a course of treatment.
Advantages
The first advantage of this examination is the possibility of early diagnosis of many diseases, which allows patients to undergo timely treatment and fully recover. Scintigraphy will show the development of certain pathologies, even if there are no changes in the organ, but only functional disorders are observed. As practice shows, timely passage of tesscrotalicular scintigraphy increases the effectiveness of treatment by 50-60%.
The second thing that characterizes scintigraphy on the positive side is safety for patients. Modern equipment minimizes the level of radiation exposure to the human body. Doctors note that during the passage of X-rays, patients receive a higher dose of radiation than during scintigraphy. Accordingly, patients may not hesitate to undergo this examination as many times as necessary to make a residual diagnosis. Moreover, radionuclides are eliminated from the body in the shortest possible time without the slightest harmful consequences.
Also, an equally important advantage of this method in comparison with others is its informativeness and efficiency of obtaining results.
Preparation and contraindications
There is no special preparation before undergoing scrotal scintigraphy. However, in some cases it will be necessary to follow certain doctor’s recommendations so that the result of the examination is as accurate as possible. For example, it may be a restriction in taking certain medications (to stimulate an erection, clean blood vessels, etc.), a ban on alcohol, smoking, and so on. The doctor himself determines what the patient needs to do, in each case there may be different recommendations.
There are few contraindications to this procedure. First of all, it is an allergy to radionuclide drugs. It is also impossible to undergo an examination if an X-ray contrast examination was done before.
