Introduction Testicular adrenal rest cell tumours (TART) are rare benign adrenocorticotropic hormone-dependent testicular tumours, which can develop in patients with congenital adrenal hyperplasia. If left untreated, they can cause testicular tissue damage and infertility. Ultrasound is the imaging modality of choice allowing for non-invasive diagnosis provided that characteristic features are seen. In recent times, magnetic resonance imaging characteristics have also been described to aid diagnosis. Case Report This case describes the imaging features of multiple bilateral TART in a young patient with congenital adrenal hyperplasia. Traditional greyscale and colour Doppler ultrasound demonstrated intratesticular, predominantly hypoechoic areas, with increased surrounding colour Doppler flow. In addition, contrast-enhanced ultrasound and strain elastography were performed, showing increased TART vascularisation and increased stiffness in the hypoechoic areas. Subsequent magnetic resonance imaging confirmed bilateral lobulated, well demarcated, intratesticular lesions, which appeared predominantly isointense on T1-weighted imaging, hypointense on T2-weighted imaging, with heterogeneous enhancement following gadolinium administration. Discussion This case illustrates the sonographic features including greyscale, colour Doppler, contrast and elastography ultrasound of TART in a patient with congenital adrenal hyperplasia. Both contrast-enhanced ultrasound and elastography can provide information about tissue properties not normally derived from conventional ultrasound and aid accurate diagnosis. Additional magnetic resonance imaging is not normally required with typical ultrasound appearances. The unusual findings seen on the ultrasound examination were likely secondary to poor compliance with treatment. Conclusion Familiarity and recognition of characteristic and uncommon imaging features of these tumours are important to avoid misdiagnosis and surgical intervention.

DERIVO 2 Embolization Device (DED2) is a new addition to the market and promises better radiopacity. 1 Aim of study The purpose of this study was to evaluate the safety and efficacy of the DED2. Methods We conducted a retrospective multicenter analysis at six interventional facilities. Patients with unruptured or ruptured intracranial aneurysms were included. The primary objective was angiographic aneurysm occlusion at 6 months as measured by the OKM grading scale. Clinical outcome according to mRS was evaluated at 6 months, with major morbidity defined as mRS 3-5. Results We included 37 patients treated with the DED2 between August 2020 and July 2021. Five patients had ruptured aneurysms. 27 patients were female, 10 male, with a medium age of 60. The median mRS was 0 (range 0-4). Average aneurysm size was 9.1 (7.9) mm, while average neck size was 6.8 (6.3) mm. In all cases the DED2 opened upon deployment. Thirty patients were eligible for clinical follow-up (81.1%). 25 (83.3%) had an mRS of 0 or 1, with no clinical deterioration in patients with pre-existing significant morbidity. Three patients died during the follow-up period, two of whom had ruptured aneurysms initially. Follow-up imaging was available in 27 patients (90%), with 23 (85.2%) demonstrating satisfactory aneurysm occlusion OKM grade C-D. Conclusion The DED2 is both safe and effective in the treatment of ruptured and unruptured intracranial aneurysms.