Comparison of Superb Microvascular Imaging With Other Doppler Methods in Assessment of Testicular Vascularity in Cryptorchidism

Superb microvascular imaging (SMI) is a new Doppler technique. Superb microvascular imaging can observe microvascular and low-velocity blood flow. Superb microvascular imaging is available in 2 modes: color SMI (cSMI) and monochrome SMI (mSMI). To evaluate testicular flow, we have compared color Doppler ultrasound (CDUS), power Doppler ultrasound (PDUS), Advanced Dynamic Flow (ADF), cSMI, and mSMI techniques. Fifty-six participants less than 36 months of age were included in the study (mean age, 18.21 +/- 1.5 months). One of the testes examined was in the scrotal sac, and the other was undescended testis (UT), and its location was at the level of the lower/middle inguinal canal. Testicular vascularization was evaluated with the CDUS, PDUS, ADF, and SMI techniques. Spot and linear signal encoding detected in the parenchyma were recorded between 0 and III for each technique. At the level of the testicle hilus, the outer boundary of the testicle was drawn manually along the long axis of each testis, and the vascularity index (VI) was automatically calculated from this area on the cSMI method. There was no significant relationship between normal and undescended testicles in terms of age, weight, height, testicle volume, and VI. Superb microvascular imaging was found to be superior in showing testicular vascularity, especially UT. The power of detecting Doppler signal in mSMI is significantly higher than in other methods (P < 0.001). The most valuable method according to the power of detecting testicular vascularity was mSMI. Next were cSMI, ADF, PDUS, and CDUS. In conclusion, the SMI technique should be included in vascular examination in pediatric patients with UT. The SMI technique can play an important role in assessing vascularization of UT.