Table 4.

Imaging modalities used to diagnose varicoceles.

Methods	Diagnostic criteria
Sonography	Tortuous, tubular, anechoic structures adjacent to the testis corresponding to dilated veins of the pampiniform plexus with calibers of 2–3 mm during the Valsalva maneuver
Color Doppler sonography	Reflux into the spermatic vein that increases during the Valsalva maneuver; classified as static (grade I), intermittent (grade II), or continuous (grade III)
Phelobography	Increase in the caliber of the internal spermatic vein with reflux into the abdominal, inguinal, scrotal, or pelvic portions of the spermatic vein, and the presence of collateral circulation
Magnetic Resonance Imaging	Dilatation of the vessels of the pampiniform plexus with signal intensity that varies depending on the flow rate and enhancement after injection of contrast medium
Scintigraphy	Intrascrotal accumulation of technetium-99-labeled red cells with reflux observed during dynamic maneuvers