Micro V Doppler assessment of testicular blood supply in the pediatric age population: may reduce the need for senior guidance in the evaluation of prepubertal torsion

Objective: We evaluated the testis vascularity in pediatric population with MicroV Doppler (MVD) and Q pack examination and to detect differences between a limited experience and a experienced senior radiologists. The inter-observer agreement in MVD and Q pack examination is evaluated. We also compared MVD and Q pack examination with color and power Doppler in demonstrating testicular blood supply in children. Material and Methods: 114 testis (between the ages of 4-14) were included in the study. Testicular microvessel structure was examined by using color, power, MicroV Doppler and Q-pack examination techniques. A grouping system was created for color, Power and MicroV Doppler to score the vascularity of the testicular parenchyma visually. Results: In our study, we confirmed the presence of testicular blood flow with MVD in all children. We found that there was no significant difference between the observers in color, power Doppler and MVD and the consistency value was higher in MVD compared to color and power Doppler. We observed a significant positive correlation between Q-pack values and patient age. Q-pac values obtained from this study increased with age. The lack of statistically significant bias indicates that the method is useful. Conclusion: MVD is a reproducible method since there is no significant interobserver variability and can easily detect acute scrotal pathologies such as prepubertal torsion for the less experienced radiologists in the early years of working life. Thus, the need for senior guidance accompanying radiology resident in the evaluation of emergency cases in children may decrease. Keywords: blood supply, micro V doppler, pediatric age population