Evaluation of detorsioned testes after torsion using advanced functional ultrasonography

This study aimed to investigate the role of advanced ultrasonographic techniques-Shear Wave Elastography (SWE) and Superb Microvascular Imaging (SMI)-in evaluating testicular parenchymal damage following surgical detorsion in patients with testicular torsion. Additionally, the study assessed the potential contribution of these modalities to clinical decision-making.

Seventeen patients who underwent surgical detorsion without orchiectomy for testicular torsion between January 2015 and January 2025 were included in the study. In each case, both the detorsed and contralateral testes were evaluated. Testicular volume, SMI score, and SWE values were measured using a standardized ultrasonography protocol. Between-group comparisons were performed using the Mann-Whitney U test, and correlations between continuous variables were analyzed using Spearman's rank correlation coefficient.

The mean age of the patients included in the study was 13.8 ± 3.6 years. In the majority of cases (76.5 %), the duration of torsion was less than 24 h. There were no statistically significant differences between detorsed and contralateral testes in terms of testicular volume, SWE values, or SMI scores (p > 0.05). However, in the detorsed group, testicular volume showed a strong negative correlation with SWE values (r = -0.6965, p = 0.002) and a positive correlation with SMI scores (r = 0.668, p = 0.003) (Tble 1).

These findings suggest that volume measurements alone may be insufficient to accurately reflect testicular function. Functional ultrasonographic modalities such as SWE and SMI may offer substantial benefits in the postoperative monitoring of detorsed testes and in predicting long-term outcomes. These advanced imaging techniques may also facilitate more objective decision-making regarding testicular preservation versus orchiectomy.