AIUM Practice Parameter for the Performance of Scrotal Ultrasound Examinations

Journal of Ultrasound in MedicineVolume 40, Issue 5 p. E30-E33 Practice ParameterFree Access AIUM Parameter for the Performance Scrotal Examinations First published: 04 March 2021 https://doi.org/10.1002/jum.15667AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text full-text accessPlease review our Terms and Conditions Use check box below share version article.I have read accept Wiley Online Library UseShareable LinkUse link a this article with your friends colleagues. Learn more.Copy URL Share linkShare onEmailFacebookTwitterLinked InRedditWechat Introduction The American Institute Medicine (AIUM) is multidisciplinary association dedicated advancing safe effective use ultrasound medicine through professional public education, research, development clinical practice parameters, accreditation practices performing examinations. was developed (or revised) by collaboration other organizations whose members examination(s) (see “Acknowledgments”). Recommendations personnel requirements, request examination, documentation, quality assurance, safety may vary among be addressed each separately. This intended provide medical community recommendations performance recording high-quality parameter reflects what considers appropriate criteria type examination but not establish legal standard care. performed specialty area are expected follow recognition that deviations occur depending on situation. Indications scrotal include limited to1, 2 following: Evaluation pain, including testicular trauma, ischemia/torsion, postsurgical infectious or inflammatory disease.3-10 palpable inguinal, intrascrotal, mass.1, 2, 11-13 asymmetry, swelling, enlargement.1, 14-16 potential intrascrotal hernia.17 Detection/evaluation varicoceles.18 male infertility.1 Follow up prior indeterminate findings.19 Localization nonpalpable testes.20, 21 inguinal testes.22 Detection an occult primary tumor patients metastatic germ cell tumor23 unexplained retroperitoneal adenopathy. neoplasms, leukemia, lymphoma.24 abnormality noted imaging studies (including computed tomography, magnetic resonance imaging, positron emission tomography). disorder sexual development.25 Qualifications Responsibilities Personnel Physicians interpreting should meet specified Training Guidelines accordance policies. Sonographers appropriately credentialed personally must supervision as defined Centers Medicare Medicaid Services Code Federal Regulations 42 CFR §410.32. Request Examination written electronic originate from physician licensed health care provider under provider's direction. information provided allow interpretation consistent relevant local facility requirements. Specifications presence testes documented either single transverse, coronal, coronal oblique image. In addition, cine loop survey scan, taken both longitudinal transverse projections, can obtained stored rest study. evaluated at least planes: transverse. Transverse images superior, mid, inferior portions testes. Longitudinal views centrally, well medially laterally. cases acute swelling some authors suggest asymptomatic side first symptomatic afterward same/similar grayscale Doppler settings.8 Each testis its entirety. size, echogenicity, blood flow epididymis compared contralateral side. Comparison best accomplished side-by-side If indication sonogram, directly imaged.1, event identified within scrotum, ipsilateral canal rings scanned. Relevant extratesticular structures evaluated. head, body, tail when technically feasible. spermatic cord supratesticular if there suspicion torsion.9, 10, 26 wall, overlying skin, Additional techniques, such Valsalva maneuver upright positioning, used needed. Any documented. Testicular volumes could using Lambert formula (length × width height 0.71) ellipsoid 0.52).27 sonography (spectral color/power imaging) necessary examinations scrotum required setting pain evaluation varicocele. used, color and/or power 1 image comparing Identical settings evaluate symmetry between Low-flow detection necessary, document flow. Documentation Accurate complete documentation essential patient Written reports images/video clips contain diagnostic archived, follow-up clinically applicable, Examination. Equipment conducted real-time scanner, preferably 7–12-MHz higher linear array transducer. A curvilinear vector transducer lower frequencies needed enlarged, recognizing tradeoff spatial resolution beam penetration. highest possible (typically 5.0–10-MHz range) providing optimal used. frequency differ frequency. Standoff pads improve imaging. Quality Safety Policies procedures related assurance improvement, safety, infection control, equipment monitoring implemented Standards Accreditation Practices. As Low Reasonably Achievable (ALARA) Principle benefits risks considered. ALARA principle observed factors affect acoustic output considering dwell time total scanning time. Further details found current publication Medical Safety. Infection Control Transducer preparation, cleaning, disinfection manufacturer AIUM's Cleaning Preparing External- Internal-Use Transducers Between Patients, Safe Handling, Coupling Gel. Monitoring protocols Acknowledgments revised College Radiology (ACR), Society Radiologists (SRU), Pediatric (SPR). We indebted many volunteers who contributed their time, knowledge, energy developing document. Collaborative Subcommittees Pat Fulgham, MD Bruce R. Gilbert, MD, PhD Harvey Nisenbaum, ACR Sheila Sheth, chair Helena Gabriel, Kristin L. Rebik, DO Pallavi Sagar, SPR Richard D. Bellah, Harris Cohen, Ricardo Faingold, SRU William Middleton, Maitray Patel, Clinical Committee Bryann Bromley, James M. Shwayder, JD, vice Nirvikar Dahiya, Rob Goodman, MBBCh, MBA, BMSc Rachel Bo-ming Liu, Jean Spitz, MPH, CAE, RDMS John Stephen Pellerito, References 1Appelbaum L, Gaitini D, Dogra VS. adults. Semin CT MR 2013; 34: 257– 273. CrossrefPubMedWeb Science®Google Scholar 2Mirochnik B, Bhargava P, Dighe MK, Kanth N. pathology. Radiol Clin North Am 2012; 50: 317– 332.vi. 3Deurdulian C, Mittelstaedt CA, Chong WK, Fielding JR. US trauma: technique, findings, management. 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