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The vascular bed of a Leydig cell tumor is wider and the blood flow velocity is higher than that of a seminoma due to more regular neovascularization. In contrast, a seminoma presents large areas of necrosis due to irregular neovascularization. This explains the different PE and WiR values. Further studies involving larger patient populations are mandatory to confirm these encouraging preliminary results.

Purpose Contrast-enhanced ultrasound (CEUS) is the application of ultrasound contrast agents (UCAs) to traditional medical sonography. The development of UCAs allowed to overcome some of the limitations of conventional B-mode and Doppler ultrasound techniques and enabled the display of the parenchymal microvasculature. Purpose of this paper is to delineate the elements of a solid and science-based technique in the execution of urinary bladder CEUS. Methods We describe the technical execution of urinary bladder CEUS and the use of perfusion softwares to perform contrast enhancement quantitative analysis with generation of time-intensity curves from regions of interest. Results During CEUS, normal bladder wall shows a wash-in time of 13 s, a time to peak (TTP) [40 s, a signal intensity (SI) \45 % and a wash-out time [80 s; Lowgrade urothelial cell carcinoma (UCC) shows a wash-in time of 13 s, a time to peak TTP [28 s, a SI \45 % and a wash-out time of 40 s; High-grade UCC shows a wash-in time of 13 s, a TTP[28 s, a SI[50 % and a wash-out time of 58 s. Conclusions CEUS is a useful tool for an accurate characterization of bladder UCC although it has some drawbacks. To avoid misunderstandings, a widely accepted classification and a standardized terminology about the most significant parameters of this application should be adopted in the immediate future.

TSS in monorchid patients may be a safe procedure leading to excellent results. We therefore consider it a valid alternative to radical orchiectomy, and US imaging is essential to guide the resection of non-palpable neoplasms and to exclude concomitant lesions.

Purpose The aim of this study was to evaluate the same kidney before and after transplantation to assess the ability of the allograft to restore blood flow, time required to achieve functional recovery after surgery and the possibility of differentiating normal from pathological allografts using color Doppler ultrasound (CDUS) flow indices: resistive index (RI)/renal cortical ratio (RCR) and scintigraphy. Materials and methods 79 living donors and 79 recipients. Donors underwent renal CDUS and scintigraphy. CDUS was repeated on the allograft 24 h, 3, 15 and 30 days after transplantation, and scintigraphy 3-5 days after transplantation. Recipients were divided into two groups on the basis of clinical and biochemical values: (A) well-functioning allografts and (B) acute pathology. Results of CDUS, RI and RCI were compared to results of scintigraphy, biochemical values and biopsy. Results Group (A) n = 60 (76 %), group (B) n = 19 (24 %); RI sensitivity was 93 %, specificity 83 %. In group (A) positive predictive value (PPV) was 94 % and in group (B) 90 %. RCR using receiver operating characteristic curve analysis yielded sensitivity 100 % and specificity 98.3 %. Scintigraphy mean values of glomerular filtration ratio and T max before transplantation were in group (A): 50.32 ml/min and 4.87 min; after transplantation 46.88 ml/ min and 4.96 min; in group (B): 48.68 ml/min and 4.63 min, after transplantation 27.89 ml/min and 10.53 min, respectively. Pearson's correlation coefficient between preoperative and postoperative results of scintigraphy was significant in group (A) (glomerular filtration ratio = 0.85, T max = 0.70) and not significant in group (B) (glomerular filtration ratio = 0.40, T max = 0.08). Conclusion This study shows that CDUS, RI and RCR are useful in postoperative evaluation of transplanted kidneys as these parameters can, after only 24 h, confirm the good condition of the allograft despite still excessive blood parameter values.Keywords Color Doppler Á Ultrasound Á Renal transplantation Á Living donor Á Blood flow indices Riassunto Scopo Scopo di questo studio è stato di valutare lo stesso rene prima e dopo il trapianto al fine di valutare la capacità dell'organo trapianto di ripristinare il flusso sanguigno, il tempo richiesto per raggiungere il recupero funzionale dopo l'intervento chirurgico e per differenziare nell'innesto il tessuto normale dal patologico con l'uso degli indici di flusso del color Doppler (CD): l'indice di resistenza (IR)/ renal cortical ratio (RCR) e la scintigrafia. Materiali e Metodi 79 donatori viventi e 79 riceventi. I donatori sono stati sottoposti a CD renale e a scintigrafia. Il CD è stato ripetuto sul tessuto trapiantato 24 ore, 3, 15 e 30 giorni dopo il trapianto e la scintigrafia, 3-5 giorni dopo il trapianto. I pazienti sono stati divisi in due gruppi sulla base dei dati clinici e biochimici: A) trapianto ben funzionante e B) patologia acuta. I risultati del CD, IR e RCR sono stati confrontati con i risultati della scintigrafia, i valori biochimici e la bio...