Role of ultrasound in diagnosing adult testicular torsion: Systematic review and meta-analysis

GreyBay Institute affiliated researchers contributed to the review article The role of ultrasound imaging in adult patients with testicular torsion: a systematic review and meta-analysis. Focusing on adults with acute scrotal pain, the study assessed the diagnostic accuracy of ultrasound for identifying testicular torsion and provides higher-quality evidence for emergency and urological decision-making.

The review followed PRISMA standards for systematic reviews and meta-analyses and used QUADAS-2 to evaluate the quality of diagnostic-accuracy studies. It synthesised published evidence available up to 5 August 2018 and summarised pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratios, and summary receiver operating characteristic results for ultrasound in adult torsion diagnosis.

Twenty-six studies involving 2,116 patients were ultimately included. The pooled sensitivity of ultrasound for diagnosing adult testicular torsion was 0.86 (95% CI: 0.79-0.91) and the pooled specificity was 0.95 (95% CI: 0.92-0.97), showing strong overall diagnostic performance in clinical practice.

Subgroup analyses showed even better performance in prospective studies, with pooled sensitivity of 0.94 (95% CI: 0.83-0.98) and pooled specificity of 0.98 (95% CI: 0.94-1.00). In studies published after 2010, pooled sensitivity and specificity were both approximately 0.95-0.98, suggesting that newer equipment and techniques have further improved ultrasound performance.

Overall, the study concludes that ultrasound is a highly useful imaging tool for diagnosing testicular torsion in adults with acute scrotal pain. It supports faster recognition, fewer missed diagnoses, and more timely surgical intervention, while also showing the value of systematic review and meta-analysis for strengthening diagnostic evidence.

Publication:
The role of ultrasound imaging in adult patients with testicular torsion: a systematic review and meta-analysis.
Koshi Ota, Keisuke Fukui, Koji Oba, Akihiro Shimoda, Masahiro Oka, Kanna Ota, Masahide Sakaue & Akira Takasu.
Journal of Medical Ultrasonics, 2019, 46: 325-334.
DOI: not listed here
Published online: 2019-03-07