The whirlpool sign predicts cases of testicular torsion with the preserved flow: a case series

Abstract Background To investigate the diagnostic characteristics of high-frequency ultrasound with color doppler flow signal in pediatric testicular torsion to increase the diagnostic accuracy.Methods Seven pediatric patients from October 2017 to August 2019 with preserved blood flow signal but surgically diagnosed as testicular torsion were retrospectively included into the study. The imaging manifestations of high-frequency ultrasonography were evaluated.Results Seven cases of testicular torsion with preserved blood flow aging from 49 days to 15 years old were included in the study. All the cases had preserved blood flow in testis, but the surgical findings showed various twist degrees from 90° to 540°. Preoperative ultrasound showed spermatic cord distortion in all cases, and the testicular long axis tilted in four cases.Conclusion In some testicular torsion cases, color doppler may show normal or increased blood flow signals in the testis. The “whirlpool sign” in the spermatic cord is an important indicator suggestive of testicular torsion.