The fulminant gangrene of the scrotum (Fournier’s gangrene). Radiology (literature review)

The fulminant gangrene of the scrotum or Fournier’s gangrene (FG) is a rare form of necrotizing fasciitis of soft tissues of the anogenital region, characterized by a rapid course and high mortality. In this review the possibility of different radiological methods, the indications for their use in FG are discussed in detail. Comparative analysis of the diagnostic value of different radiological methods and their place in the diagnostic algorithm of this disease are considered. Radiological methods are used in diagnostically uncertain cases, to clarify the causes for the FG, in planning surgical intervention and evaluation of treatment effectiveness FG. At the present time of radiological methods of examination in FG used conventional radiography (CR), ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). CT is the method of choice in diagnosing FG. CT allows to quickly and with high reliability to diagnose FG, determines the cause, extent of spread of the disease and the extent of surgical intervention. Diagnostic capabilities of MRI with FG comparable with the diagnostic capabilities of CT. However, the duration of the study and somatically heavy contingent of patients limit the use of MRI in this disease. CR and US are the primary method of imaging FG and are used when CT and MRI is unavailable or contraindicated. They can be useful for use in intensive care and positive results urgently to start therapeutic measures. In the absence of radiation exposure US is particularly indicated for pediatric patients. With differential diagnostic purpose ultrasound may also be recommended for exclusion acute inguinal-scrotal region, simulating the FG.