Testicular adrenal rest tumors in boys with congenital adrenal hyperplasia: 3D US and elastography – Do we get more information for diagnosis and monitoring?

Jędrzejewski, Grzegorz; Beń‐Skowronek, Iwona; Woźniak, Magdalena Maria; Brodzisz, Agnieszka; Budzyńska, Elżbieta; Wieczorek, Paweł

doi:10.1016/j.jpurol.2013.02.008

Cited by 18 publications

(9 citation statements)

References 15 publications

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“…US elastography needs to be evaluated more in testicular focal lesions, so as to assess its benefits. In our experience and in some cases reported, US elastography may reveal a high degree of stiffness of Leydig cell tumors, 29 germ cell tumors, 30 testicular infarct, 31 adrenal rests, 32 and other diseases. B-mode US, color Doppler US, SWE, and CEUS must be combined to help the characterization.…”

Section: Discussionsupporting

confidence: 54%

Burned-Out Testis Tumors in Asymptomatic Infertile Men: Multiparametric Sonography and MRI Findings

et al. 2016

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Multiparametric testicular ultrasound and magnetic resonance imaging (MRI) findings were analyzed in a series of 10 infertile asymptomatic men presenting with pathologically confirmed burned-out testicular tumors. Color/power Doppler ultrasound (CDUS), shear wave elastography (SWE), contrast-enhanced ultrasonography (CEUS), and MRI were performed on 10, 5, 6, and 7 patients, respectively. All lesions appeared as a hypoechoic and hypovascular nodular area at CDUS, SWE, CEUS CDUS, and CEUS (if performed). Shear wave elastography showed a stiffer nodular area compared with the surrounding/contralateral tissues (13 versus 2 kPa); MRI revealed a well-delineated nodular area in hypointense signal on T2, a high apparent diffusion coefficient value, and a lack of enhancement.

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Section: Discussionsupporting

confidence: 54%

Burned-Out Testis Tumors in Asymptomatic Infertile Men: Multiparametric Sonography and MRI Findings

et al. 2016

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“…The normal testis demonstrates a homogeneous medium hardness at elastography (Jedrzejewski et al, 2013) (Fig. 6).…”

Section: Discussionmentioning

confidence: 97%

“…Focal lesions can often be recognized as harder than the surrounding testicular tissue, with some important exceptions reported with hematomas or mixed fluid lesions (Patel et al ., 2014; Yusuf et al ., 2015). Normal testis parenchyma is hard, but compared with the even harder solid tumorous tissue, it has a relatively softer appearance, displaying areas of green and light blue (Jedrzejewski et al ., 2013). Elastography has proven useful for studying focal lesions in various organs (Brock et al ., 2012; Cosgrove et al ., 2013; Cantisani et al ., 2015) and a possible role in the diagnosis of focal testicular lesions was recently advocated.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of qualitative and strain ratio elastography in the differential diagnosis of non‐palpable testicular lesions

et al. 2016

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SummaryThe purpose of this study was to evaluate prospectively the accuracy of qualitative and strain ratio elastography (SE) in the differential diagnosis of non‐palpable testicular lesions. The local review board approved the protocol and all patients gave their consent. One hundred and six patients with non‐palpable testicular lesions were consecutively enrolled. Baseline ultrasonography (US) and SE were correlated with clinical and histological features and ROC curves developed for diagnostic accuracy. The non‐palpable lesions were all ≤1.5 cm; 37/106 (34.9%) were malignant, 38 (35.9%) were benign, and 31 (29.2%) were non‐neoplastic. Independent risk factors for malignancy were as follows: size (OR 17.788; p = 0.002), microlithiasis (OR 17.673, p < 0.001), intralesional vascularization (OR 9.207, p = 0.006), and hypoechogenicity (OR, 11.509, p = 0.036). Baseline US had 89.2% sensitivity (95% CI 74.6–97.0) and 85.5% specificity (95% CI 75.0–92.8) in identifying malignancies, and 94.6% sensitivity (95% CI 86.9–98.5) and 87.1% specificity (95% CI 70.2–96.4) in discriminating neoplasms from non‐neoplastic lesions. An elasticity score (ES) of 3 out of 3 (ES3, maximum hardness) was recorded in 30/37 (81.1%) malignant lesions (p < 0.001). An intermediate score of 2 (ES2) was recorded in 19/38 (36.8%) benign neoplastic lesions and in 22/31 (71%) non‐neoplastic lesions (p = 0.005 and p = 0.001 vs. malignancies). None of the non‐neoplastic lesions scored ES3. Logistic regression analysis revealed a significant association between ES3 and malignancy (χ2 = 42.212, p < 0.001). ES1 and ES2 were predictors of benignity (p < 0.01). Overall, SE was 81.8% sensitive (95% CI 64.8–92.0) and 79.1% specific (95% CI 68.3–88.4) in identifying malignancies, and 58.6% sensitive (95% CI 46.7–69.9) and 100% specific (95% CI 88.8–100) in discriminating non‐neoplastic lesions. Strain ratio measurement did not improve the accuracy of qualitative elastography. Strain ratio measurement offers no improvement over elastographic qualitative assessment of testicular lesions; testicular SE may support conventional US in identifying non‐neoplastic lesions when findings are controversial, but its added value in clinical practice remains to be proven.

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“…They found that stiffness increased and volume decreased as age increased. Following this study, testicular elastography was used to examine various types of testicular focal lesions, torsion or segmental infarctions [13,[18][19][20][21][22][23][24]. These studies demonstrated the feasibility of elastography for evaluating elasticity in normal and diseased testes.…”

Section: Discussionmentioning

confidence: 99%

Testicular volume and elasticity changes in young children with undescended testes

et al. 2017

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Aims: To evaluate the differences and changes of testicular volume and elasticity in normal (NL) testes and undescended testes (UDTs) of children using shear wave elastography (SWE).Materials and methods: Testicular ultrasound images from children younger than 60 months old were retrospectively reviewed. Testicular volumes and elasticities were compared between the UDT group and NL group. In patients with unilateral UDT (uUDT), we also compared the values between uUDT and contralateral grossly normal (CGN) testis groups.Results: There were 25 UDTs including 4 bilateral in the UDT groupand 54 normal testes in the NL group. While testicular volume was significantly smaller in UDT (vs. NL) and uUDT (vs. CGN) groups, the elasticity was not different. Testicular volume was positively correlated with age in both NL (r=0.474) and CGN (r=0.729) groups (p<0.001), while there was no correlation in the UDT group. Testicular stiffness showed negative correlation with age in the NL group (r=-0.390, p=0.004) and positive correlation in the UDT group (r=0.426, p=0.034).Conclusions: Instead of increasing volume and decreasing stiffness of normal testes during development of the early 60 months, UDTsexhibited smaller volume and increasing stiffness. The CGN testes of uUDT patients showed increasing volume without stiffness change.

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Testicular adrenal rest tumors in boys with congenital adrenal hyperplasia: 3D US and elastography – Do we get more information for diagnosis and monitoring?

Cited by 18 publications

References 15 publications

Burned-Out Testis Tumors in Asymptomatic Infertile Men: Multiparametric Sonography and MRI Findings

Burned-Out Testis Tumors in Asymptomatic Infertile Men: Multiparametric Sonography and MRI Findings

Diagnostic value of qualitative and strain ratio elastography in the differential diagnosis of non‐palpable testicular lesions

Testicular volume and elasticity changes in young children with undescended testes

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