Utility of High-Resolution Ultrasound and Color Doppler in the Diagnosis of Scrotal Pathologies: A Cross-Sectional Study at a Tertiary Care Center in India

Background: Scrotal pathologies, including inammatory, vascular, neoplastic, and traumatic conditions, pose diagnostic challenges due to overlapping clinical presentations. High-resolution ultrasound with color Doppler is a non-invasive, radiation-free modality widely used for evaluation, but its diagnostic accuracy and correlation with histopathology require further validation in diverse populations. Aim: To evaluate the diagnostic utility of high-resolution ultrasound and color Doppler in scrotal pathologies, focusing on imaging ndings, resistive index (RI), pulsatility index (PI), and their correlation with histopathological diagnoses. Methods: This cross-sectional study, conducted at Sri Aurobindo Medical College, Indore, India, from June 2023 to December 2024, enrolled 100 patients with scrotal pathologies. Participants underwent high-resolution ultrasound and color Doppler using GE Voluson E8 and Logiq P7 machines with a 5–12 MHz linear probe. Lesions were assessed for laterality, location, echotexture, vascularity, RI, and PI. Findings were correlated with histopathology in 78 cases. Descriptive statistics, Chi-square tests (p < 0.05), and diagnostic performance metrics (sensitivity, specicity, PPV, NPV) were calculated. Results: The mean age was 38.2 ± 15.6 years. Inammatory pathologies (48%) were most common, followed by vascular/congenital (22%), neoplastic (8%), and traumatic (10%). Hydrocele (24%) and epididymo-orchitis (20%) predominated. Ultrasound showed hypoechoic lesions (58%), heterogeneous echotexture (42%), and calcications (12%). Color Doppler revealed increased vascularity in inammatory conditions (85%) and absent ow in torsion (100%). Mean RI and PI were lower in inammatory cases (0.42 ± 0.06, 0.78 ± 0.12) than normal (0.58 ± 0.08, 1.02 ± 0.15). Ultrasound correlated with histopathology in 92.3% of cases, with sensitivity 96%, specicity 92%, PPV 94%, and NPV 95%. Conclusion: High-resolution ultrasound with color Doppler is a highly accurate, safe, and reliable tool for diagnosing scrotal pathologies, particularly for differentiating inammatory, ischemic, and neoplastic conditions, supporting its role as the rstline imaging modality.