This article discusses the current clinical role and scope of functional radionuclide imaging using testicular perfusion scintigraphy with ^99mTc-pertechnetate in patients presenting with an acute hemiscrotum for an early and reliable diagnosis of testicular torsion. The technique of testicular perfusion scintigraphy is described, and the characteristic findings are detailed with examples. The imaging characteristics of the various phases of testicular torsion and its differentiation from epididymitis and/or epididymo-orchitis and the other related conditions presenting as an acute hemiscrotum are detailed. In some cases, further evaluation by SPECT imaging increases the clarity and accuracy of diagnosis and, on occasion, hybrid SPECT/CT in selected complicated cases improves the diagnostic yield of the perfusion scintigraphy. Ultrasonographic and color Doppler findings are described concurrently with the scintigraphic findings. The several case examples presented demonstrate the additional clinical benefit of complementing functional and structural imaging for improving the sensitivity, specificity and accuracy of testicular imaging in the diagnosis.

本文讨论了使用^{99m Tc-高}锝酸盐睾丸灌注闪烁扫描技术对患有急性半阴囊的患者进行功能性放射性核素显像的当前临床作用和范围，以对睾丸扭转进行早期和可靠的诊断。描述了睾丸灌注闪烁扫描技术，并举例详细说明了其特征性发现。详细介绍了睾丸扭转各个阶段的影像学特征及其与附睾炎和/或附睾睾丸炎以及其他表现为急性半阴囊的相关病症的区别。在某些情况下， SPECT成像的进一步评估可提高诊断的清晰度和准确性，有时，在选定的复杂病例中混合 SPECT/CT 可以提高灌注闪烁扫描的诊断率。超声检查和彩色多普勒检查结果与闪烁检查结果同时描述。所提供的几个案例证明了补充功能和结构成像对于提高睾丸成像诊断的敏感性、特异性和准确性的额外临床益处。