1
|
Močnik M, Marčun Varda N. Ultrasound Elastography in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1296. [PMID: 37628295 PMCID: PMC10453784 DOI: 10.3390/children10081296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023]
Abstract
Ultrasound elastography is a novel ultrasound technique, being extensively researched in children in the last decade. It measures tissue elasticity with the observation of tissue response after an external stimulus. From research to clinical practice, ultrasound elastography has evolved significantly in liver fibrosis evaluation in children; however, several other applications of the technique are available in both clinical practice and research environments. Practically, in children any organ can be assessed, including the brain in early ages, along with muscle and connective tissue elasticity evaluation, spleen, kidney, skin, lymphatic tissue, etc. The elastography method, age, body mass index and technical points should be considered when performing ultrasound elastography. This review highlights its vast potential as a diagnostic tool in the pediatric population, where ultrasound is a dominant imaging tool; however, the indications and exam protocol for its clinical use in several fields in pediatrics have yet to be elucidated.
Collapse
Affiliation(s)
- Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, 2000 Maribor, Slovenia;
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, 2000 Maribor, Slovenia;
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
| |
Collapse
|
2
|
Elastography in the Urological Practice: Urinary and Male Genital Tract, Prostate Excluded—Review. Diagnostics (Basel) 2022; 12:diagnostics12071727. [PMID: 35885631 PMCID: PMC9320571 DOI: 10.3390/diagnostics12071727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this article is to review the utility of elastography in the day-to-day clinical practice of the urologist. An electronic database search was performed on PubMed and Cochrane Library with a date range between January 2000 and December 2021. The search yielded 94 articles that passed the inclusion and exclusion criteria. The articles were reviewed and discussed by organ, pathology and according to the physical principle underlying the elastographic method. Elastography was used in the study of normal organs, tumoral masses, chronic upper and lower urinary tract obstructive diseases, dysfunctions of the lower urinary tract and the male reproductive system, and as a pre- and post-treatment monitoring tool. Elastography has numerous applications in urology, but due to a lack of standardization in the methodology and equipment, further studies are required.
Collapse
|
3
|
Koras O, Gorur S, Bayramogulları H, Ilhan G, Gokalp F, Kacmaz M, Ilgezdi A, Yıldırak E, Sigva H, Tamkac N, Porgalı SB. Elastographic evaluation of the effect of sickle cell anemia on testicles: a prospective study. Andrologia 2022; 54:e14481. [PMID: 35610190 DOI: 10.1111/and.14481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/11/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022] Open
Abstract
To quantitatively determine testicular tissue stiffness values using shear wave elastography (SWE) in males that have sickle cell anemia (SCA) and to evaluate the relationship between elastography results and semen analysis parameters and hormone levels. Fifty patients diagnosed with SCA and followed up in the hematology outpatient clinic were evaluated in the urology outpatient clinic as the study group. In addition, there were 88 patients without any SCA-related complaints in the control group. We compared these groups with respect to their values, spermiogram parameters, testicular volume, and SWE values. Among patients in the SCA group, 28% had impaired sperm parameters. When testicular elastography was assessed, the testicular volumes were materially lower in the SCA group in comparison to the control group [right testicular volume: 14.76 (12.77-18.12) and 19.68 (15.12-24.18), respectively, p < 0.001; left testicular volume: 14.11 (11.06-17.32) and 16.59 (13.38-20.13), respectively, p = 0.015]. Additionally, the left testis central stiffness and the left testis inferior stiffness were significantly higher in the SCA group (p < 0.001 and p = 0.014, respectively). The age and hydroxyurea use had a worse effect on sperm parameters in patients with SCA (odds ratio: -0.161 and -1.914, standard deviation: 0.071 and 0.921, and p = 0.024 and p = 0.038, respectively). We consider that the technique utilized in this study for SWE values is fast and can be adopted as a reliable diagnostic tool and follow-up practice in routine clinical practice to evaluate the acuteness of damage to the testicles in patients having SCA.
Collapse
Affiliation(s)
- Omer Koras
- Department of Urology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Sadık Gorur
- Department of Urology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Hanifi Bayramogulları
- Department of Radiology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Gul Ilhan
- Department of Hematology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Fatih Gokalp
- Department of Urology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Murat Kacmaz
- Department of Hematology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Alican Ilgezdi
- Department of Radiology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Ekrem Yıldırak
- Department of Urology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Hakan Sigva
- Department of Urology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Nezih Tamkac
- Department of Urology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Sefa Burak Porgalı
- Department of Urology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| |
Collapse
|
4
|
Yüzkan S, Çilengir AH. Shear Wave Elastography for Assessment of Testicular Stiffness in Patients with Varicocele: A Prospective Comparative Study. J Med Ultrasound 2022; 30:277-281. [PMID: 36844770 PMCID: PMC9944817 DOI: 10.4103/jmu.jmu_218_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/28/2022] [Accepted: 02/15/2022] [Indexed: 12/28/2022] Open
Abstract
Background The purpose of this study was to use ultrasonography and shear wave elastography (SWE) to assess stiffness and volume of testes in adult patients with varicocele, to compare the results with those of normal contralateral testes of the same patients and healthy testes of control subjects. Methods In this IRB-approved prospective comparative study, 58 patients with varicocele (116 testes) and 58 control patients (116 testes) were enrolled. A total of 66 testes with varicocele were added to group A, their 50 healthful contralateral testes were added to Group B, and 116 healthy control testes were added to Group C. Analysis of variance (one way ANOVA) test was used to compare groups and Student's t-test was used for their binary comparisons. The correlation between the testicular stiffness and volume was studied using Pearson's correlation test. Results There was not a significant difference in the mean SWE values between three groups and also, between two-group comparisons (P < 0.05). In the mean testicular volumes, a significant difference was observed between Groups A and C (P = 0.028). Conversely, there was not a significant difference between Groups A and B (P = 0.907) or Groups B and C (P = 0.094). A meaningful correlation between testicular stiffness and volume was not detected for each group. Conclusion A significant correlation was not determined between SWE values and varicocele, and also between SWE values and testicular volume. We advise that more studies with larger populations of patients are required to verify the effectiveness of SWE in predicting testicular parenchymal damage.
Collapse
Affiliation(s)
- Sabahattin Yüzkan
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey,Address for correspondence: Dr. Sabahattin Yüzkan, Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul 34000, Turkey. E-mail:
| | - Atilla Hikmet Çilengir
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| |
Collapse
|
5
|
Mulati Y, Li X, Maimaitiming A, Apizi A, Wang Y. Is there any predictive value of testicular shear wave elastic modulus in testicular functions for varicocele patients? Andrologia 2022; 54:e14393. [PMID: 35277869 DOI: 10.1111/and.14393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yelisudan Mulati
- Urology Department The First Affiliated Hospital of Xinjiang Medical University Xinjiang Medical University Urumqi Xinjiang China
| | - Xiaodong Li
- Urology Department Xinjiang Clinical Research Center for Genitourinary System The First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang China
| | - Abulaiti Maimaitiming
- Urology Department Xinjiang Clinical Research Center for Genitourinary System The First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang China
| | - Aireti Apizi
- Urology Department Xinjiang Clinical Research Center for Genitourinary System The First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang China
| | - Yujie Wang
- Urology Department Xinjiang Clinical Research Center for Genitourinary System The First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang China
| |
Collapse
|
6
|
Ahmed AT. Utility of shear wave ultrasound elastography in evaluation of testicular stiffness in patients with varicocele. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00651-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Testicular varicocele is the most frequent cause of male infertility. The study aimed at evaluation of testicular stiffness in patients with varicocele measured by shear wave ultrasound elastography (SWE) in correlation to patient semen analysis (total sperm count) and varicocele grade. This case–control study involved 50 patients (40 patients with bilateral testicular varicocele and 10 patients with unilateral Lt. testicular varicocele of different grades) and 25 healthy controls. All participants underwent physical examination, semen analysis (patient group subdivided in two groups: group A; normospermic and group B; oligospermic), scrotal grey scale and Doppler ultrasound, and shear wave ultrasound elastography with measurement of mean testicular stiffness. Evaluation of testicular stiffness and correlation to varicocele grade and semen analysis (total sperm count) were done.
Results
The mean testicular stiffness value measured by SWE in patients with testicular varicocele was greater than that of healthy controls (7.46 ± 1.64 kPa vs. 3.84 ± 0.62 kPa, P < 0.001). The mean testicular stiffness value in group B exceeded that of group A (8.57 ± 1.53 kPa vs. 6.34 ± 1.76 kPa, P = 0.001). A moderate positive correlation was found between mean testicular stiffness value and the varicocele grade (P = 0.01) which was more evident in group B than in group A (P = 0.01).
Conclusions
Testicular ultrasound SWE is a quantitative noninvasive imaging method which helps in the assessment of testicular parenchymal changes due to varicocele. Higher testicular stiffness values were found in testes of patients with varicocele, more in oligospermic patients than the testes of healthy controls. Testicular stiffness is moderately correlated to varicocele grade.
Collapse
|
7
|
Bello JO, Bhatti KH, Gherabi N, Philipraj J, Narayan Y, Tsampoukas G, Shaikh N, Papatsoris A, Moussa M, Buchholz N. The usefulness of elastography in the evaluation and management of adult men with varicocele: A systematic review. Arab J Urol 2021; 19:255-263. [PMID: 34552777 PMCID: PMC8451612 DOI: 10.1080/2090598x.2021.1964256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Objective To review the role of elastography in the evaluation and decision-making of adult, infertile men with varicocele. Methods A systematic search using the terms (Elastography) AND (Varicocele), (Stiffness) AND (Varicocele), (Elastography) AND (Male infertility) was performed in Pubmed/Medline. Studies reporting a) elastographic characteristics in varicocele-bearing comparing to normal testicles, and b) the correlation of elastography with varicocele grading, parameters of spermatogenesis, and outcomes of varicocele treatment were selected. Exclusion criteria were animal, adolescents, abstracts, and non-English language studies. Results In total, 453 articles were identified; 11 eligible studies were selected. Several modalities were used (shear wave elastography, strain elastography, quasistatic ultrasound elastography, acoustic radiation force impulse). Varicocele-bearing testicles have significantly different stiffness and elasticity in comparison to normal and non-varicocele testicles. Although not in full agreement, elastography readings are correlated with semen parameters. Conflicting results were reported regarding grading as most of the studies failed to demonstrate a significant correlation. Shear wave elastography showed a significant correlation with the improvement in semen parameters after varicocelectomy, but the association with pregnancy rates is unknown. Finally, no studies were identified comparing elastography with other modalities. Conclusions Elastography can detect changes in the architecture of varicocele-bearing testicles. Although the role of the modality in grading is uncertain, elastography showed a meaningful correlation with spermatogenesis parameters. Importantly, elastography readings could predict the improvement in semen parameters after varicocelectomy which is useful in terms of decision-making in infertile men with varicocele. Abbreviations ARFI: acoustic radiation force impulse; CDUS: colour Doppler ultrasonography; DWI: diffusion-weighted imaging; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SWE: shear wave elastography; VC: varicocele.
Collapse
Affiliation(s)
- Jibril Oyekunle Bello
- U-merge Ltd. (Urology for Emerging Countries), London, UK.,Urology unit, Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Kamran Hassan Bhatti
- U-merge Ltd. (Urology for Emerging Countries), London, UK.,Urology section Hamad Medical Corporation Alkhor Qatar
| | - Nazim Gherabi
- U-merge Ltd. (Urology for Emerging Countries), London, UK.,Andrology committee of the Algerian Association of Urology, Algiers, Algeria
| | - Joseph Philipraj
- U-merge Ltd. (Urology for Emerging Countries), London, UK.,Department of Urology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - Yash Narayan
- U-merge Ltd. (Urology for Emerging Countries), London, UK.,Department of Urology, The Princess Alexandra Hospital NHS Trust, Harlow, UK
| | - Georgios Tsampoukas
- U-merge Ltd. (Urology for Emerging Countries), London, UK.,Department of Urology, The Princess Alexandra Hospital NHS Trust, Harlow, UK
| | - Nisar Shaikh
- U-merge Ltd. (Urology for Emerging Countries), London, UK.,Department of Urology, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, Larkana, Pakistan
| | - Athanasios Papatsoris
- U-merge Ltd. (Urology for Emerging Countries), London, UK.,2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mohamad Moussa
- U-merge Ltd. (Urology for Emerging Countries), London, UK.,Department of Urology, Al Zahraa Hospital, University Medical Center, Lebanese University, Beirut, Lebanon
| | - Noor Buchholz
- U-merge Ltd. (Urology for Emerging Countries), London, UK
| |
Collapse
|
8
|
Ryu YJ, Choi YH, Kim JY, Cheon JE, Kim WS, Kim IO, Park JE, Im YJ, Park K. A preliminary study of shear-wave elastography for the evaluation of varicocele in adolescents and young adults. ULTRASONOGRAPHY (SEOUL, KOREA) 2021; 41:131-139. [PMID: 34237827 PMCID: PMC8696133 DOI: 10.14366/usg.20213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/10/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE The purpose of this study was to use shear-wave elastography (SWE) to assess testicular stiffness changes during the Valsalva maneuver in adolescents and young adults with varicocele, to compare these changes according to clinical severity, and to evaluate the role of SWE in the diagnosis of varicocele. METHODS This study included patients undergoing testicular ultrasonography for the diagnosis of varicocele or for post-varicocelectomy follow-up between June 2016 and February 2017. Fifty-four testicles of 27 consecutive patients (mean age, 15.9 years) were classified by clinical grade (grade 0-3). Using SWE, mean testicular stiffness (Emean) was measured at rest and during the Valsalva maneuver. The correlations between multiple ultrasonographic parameters (volume asymmetry, Emean at rest, and absolute and percentage changes in Emean during the Valsalva maneuver) and clinical grade were assessed using the Spearman correlation test. RESULTS The Emean at rest was similar across clinical grades. During the Valsalva maneuver, increased testicular stiffness was frequently observed in patients with grade 2 or 3 varicocele but rarely observed in those with grade 0 or 1 varicocele. The changes in Emean were positively correlated with the clinical grade (all P<0.001), whereas the Emean at rest and volume asymmetry were not (all P>0.05). CONCLUSION A transient, reversible increase in testicular stiffness during the Valsalva maneuver was observed in adolescents with high-grade varicocele, and the degree of stiffness change was correlated with the clinical grade. Stiffness change identified using SWE during the Valsalva maneuver is a potential surrogate indicator of venous congestion.
Collapse
Affiliation(s)
- Young Jin Ryu
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Young Hun Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Ji Young Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Eun Cheon
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Woo Sun Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - In-One Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Ji Eun Park
- Department of Radiology, Ajou University Medical Center, Suwon, Korea
| | - Young Jae Im
- Division of Pediatric Urology, Seoul National University Children's Hospital, Seoul, Korea.,Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Kwanjin Park
- Division of Pediatric Urology, Seoul National University Children's Hospital, Seoul, Korea.,Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
9
|
Muršić M, Sjekavica I, Šimunović M, Ježek D. THE ROLE OF ULTRASOUND ELASTOGRAPHY IN THE DIAGNOSIS OF PATHOLOGIC CONDITIONS OF TESTICLES AND SCROTUM. Acta Clin Croat 2021; 60:41-49. [PMID: 34588720 PMCID: PMC8305351 DOI: 10.20471/acc.2021.60.01.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/06/2020] [Indexed: 11/24/2022] Open
Abstract
Several years ago, elastography emerged as a potentially very useful ultrasound technique that is currently used in diagnostic workup of the breast, liver and some other organ systems, whereas for other ones it is still mainly in the phase of research. The aim of the study was to compare elasticity index (EI) of testicles using strain elastography in healthy subjects and those with pathologic changes of testicles/scrotum. A total of 117 patients were included in the study. Measurements were performed on a Logiq E9 ultrasound system using strain elastography. In healthy subjects, the mean EI value was 1.34±0.35 for right testis and 1.49±0.47 for left testis. Increased mean EI values were found in the following six conditions: patients with varicocele, infertile patients, solitary testis after orchidectomy of the other testicle because of tumor, patients with testicular tumors, patients after orchidopexy of undescended testicle, and patients with congenitally smaller testicle. There is a paucity of literature data on the use of elastography in testes, as well as on normal elastography values in testicular tissue. Strain elastography was demonstrated to be a valuable method to acquire additional information in patients with pathologic changes in testicles/scrotum. These data provide reference values for further research in a larger sample of subjects.
Collapse
Affiliation(s)
| | - Ivica Sjekavica
- 1Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Marko Šimunović
- 1Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Davor Ježek
- 1Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
| |
Collapse
|
10
|
Ates F, Durmaz MS, Sara HI, Kara T. Comparison of testicular vascularity via superb microvascular imaging in varicocele patients with contralateral normal testis and healthy volunteers. J Ultrasound 2021; 25:59-65. [PMID: 33409864 PMCID: PMC8964885 DOI: 10.1007/s40477-020-00553-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/13/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE In this study, we aimed to determine vascular changes in the testes in patients with varicocele using the two-dimensional color superb microvascular imaging vascular index (2DcSMIVI) and compared them with those of the normal contralateral testes of the same patients as well as the normal testes of control subjects without varicocele. METHODS A total of 114 participants and 228 testes were included in the study. 63 patients with varicocele and 51 asymptomatic volunteers were included. In total, 70 testes with varicocele (group A), 56 normal contralateral testes (Group B), and 102 bilateral normal testes were classified (Group C). Participants' testicular volume and 2DcSMIVI values were obtained via superb microvascular imaging. Testes with varicocele were graded according to Sarteschi classification. RESULTS Statistically significant differences in mean testicular volume were observed among the three groups. The volume and 2DcSMIVI values of the varicocele side testes were significantly lower than those of groups B and C. Significant differences were also observed between Sarteschi grade and 2DcSMIVI values in group A. CONCLUSION We can determine impaired microcirculation of varicocele side testes quantitatively with the 2DcSMIVI technique, and obtained VI values can be used effectively in diagnosis and follow-up of the damage in testes. Our results show that 2DcSMIVI values can play a significant role in the evaluation of testicular blood flow as a predictive sign of testicular damage.
Collapse
Affiliation(s)
- Fatih Ates
- Department of Radiology, Medicine Faculty, Selçuk University, Konya, Turkey.
| | | | - Halil Ibrahim Sara
- Departments of Radiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Turgay Kara
- Department of Radiology, Medicine Faculty, Sutcu İmam University, Kahramanmaraş, Turkey
| |
Collapse
|
11
|
Shi LQ, Sun JW, Miao HH, Zhou XL. Comparison of Supersonic Shear Wave Imaging-Derived Renal Parenchyma Stiffness Between Diabetes Mellitus Patients With and Without Diabetic Kidney Disease. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1630-1640. [PMID: 32404297 DOI: 10.1016/j.ultrasmedbio.2020.03.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 03/11/2020] [Accepted: 03/24/2020] [Indexed: 05/28/2023]
Abstract
This study aims to evaluate the difference in renal parenchyma stiffness assessed by measuring Young's modulus (YM) using a supersonic shear wave imaging (SSI) technique among healthy patients and patients with type 2 diabetes mellitus (DM) with and without diabetic kidney disease (DKD). We analyzed the correlations of YM with clinical information and conventional ultrasound parameters. All patients (N = 124) were divided into three groups: (i) healthy patients (patients without kidney disease or type 2 DM, N = 31); (ii) patients with type 2 DM without kidney disease (N = 38); and (iii) patients with DKD (N = 55). Conventional and SSI ultrasound examinations were performed in all individuals for both kidneys. Then, we recorded renal length, width, parenchyma thickness, interlobar arterial resistive index (RI) and values of mean, mininum and maximum YM. The mean values of these parameters for the left and right kidneys were calculated for statistical analysis. Statistical significance was considered at p < 0.05. Among all ultrasound parameters, the mean YM demonstrated the largest area under the receiver operating characteristic (ROC) curve (0.860). The areas under the ROC curve (AUCs) for renal length, width, parenchyma thickness, interlobar arterial RI, minimum YM and maximum YM were 0.493, 0.616, 0.507, 0.733, 0.848 and 0.794, respectively. The corresponding cutoff value of mean YM was 31.73 kPa, with a sensitivity of 85.5% and a specificity of 71.0%. The mean YM in patients with type 2 DM without kidney disease (31.44 ± 3.83 kPa) was significantly higher than that in the healthy group (26.45 ± 4.32 kPa) and lower than that in the DKD group (37.60 ± 6.56 kPa). Patients with type 2 DM without kidney disease were considered as stage 0 of DKD. Thus, the mean YM in the control group was significantly lower than that in the stage 0, 2, 3, 4 and 5 subgroups. The mean YM in the stage 0-2 subgroups was lower than that in the stage 5 group, and the mean YM in the stage 0 group was lower than that in the stage 4 group. In the DKD group, the mean YM had a positive correlation with cystine-c (r = 0.634), urea (r = 0.596), creatine (r = 0.690), uric acid (r = 0.263), albumin/creatinine ratio (r = 0.428) and the presence or absence of diabetic retinopathy (r = 0.354). The mean YM also had a negative correlation with the estimated glomerular filtration rate (r = -0.657). SSI is a non-invasive method with which to diagnose DKD and has a performance superior to that of conventional ultrasound. In addition, SSI may provide a secondary index for the staging of DKD and the monitoring of renal damage in type 2 DM patients.
Collapse
Affiliation(s)
- Li-Qiong Shi
- In-patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jia-Wei Sun
- In-patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Huan-Huan Miao
- In-patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xian-Li Zhou
- In-patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
| |
Collapse
|
12
|
Xiropotamou O, Tsili AC, Astrakas L, Ntorkou A, Maliakas V, Sofikitis N, Argyropoulou MI. A preliminary study of the biochemical environment of infertile testes with clinical varicocele. Eur J Radiol 2020; 127:108989. [DOI: 10.1016/j.ejrad.2020.108989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/31/2020] [Accepted: 04/02/2020] [Indexed: 12/18/2022]
|
13
|
Huang DY, Pesapane F, Rafailidis V, Deganello A, Sellars ME, Sidhu PS. The role of multiparametric ultrasound in the diagnosis of paediatric scrotal pathology. Br J Radiol 2020; 93:20200063. [PMID: 32271626 PMCID: PMC10993215 DOI: 10.1259/bjr.20200063] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 02/06/2023] Open
Abstract
Multiparametric ultrasound (MPUS), combining conventional techniques (greyscale and colour Doppler ultrasound), ultrasound strain elastography, and contrast-enhanced ultrasound (CEUS), has been successfully used in the assessment of adult scrotal pathology. Contrast-enhanced ultrasound can confidently establish testicular tissue vascularity even in the small-volume paediatric testis. Elastography provides further assessment of tissue stiffness, potentially adding useful diagnostic information. In children, ultrasonography is particularly advantageous, being safe, radiation-free and negating the need for sedation or general anaesthesia during the imaging evaluation. In this review article, we aim to familiarise readers with the MPUS scanning protocol used for paediatric scrotal examination and provide an overview of scrotal MPUS features, with particular focus to clinical indications where MPUS may be advantageous over conventional ultrasonography.
Collapse
Affiliation(s)
- Dean Y. Huang
- Department of Radiology, King’s College Hospital,
London. Denmark Hill, London SE5 9RS
U.K, United Kingdom
| | - Filippo Pesapane
- Breast Imaging Division, IEO European Institute of Oncology
IRCCS, Via Giuseppe Ripamonti 435, 20141,
Milan, Italy
| | - Vasileios Rafailidis
- Department of Radiology, King’s College Hospital,
London. Denmark Hill, London SE5 9RS
U.K, United Kingdom
| | - Annamaria Deganello
- Department of Radiology, King’s College Hospital,
London. Denmark Hill, London SE5 9RS
U.K, United Kingdom
| | - Maria E. Sellars
- Department of Radiology, King’s College Hospital,
London. Denmark Hill, London SE5 9RS
U.K, United Kingdom
| | - Paul S Sidhu
- Department of Radiology, King’s College Hospital,
London. Denmark Hill, London SE5 9RS
U.K, United Kingdom
| |
Collapse
|
14
|
Turna O, Aybar MD. Testicular stiffness in varicocele: evaluation with shear wave elastography. Ultrasonography 2020; 39:350-355. [PMID: 32326674 PMCID: PMC7515660 DOI: 10.14366/usg.19087] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 03/07/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE This study was conducted to evaluate the potential role of shear wave elastography (SWE) in the evaluation of testes in patients with varicocele. METHODS A total of 116 testes of 58 patients with left-sided varicocele and 58 testes of 29 age-matched healthy controls were included in the study. The patients' testes were classified into groups A (normospermic) and B (oligospermic) based on the presence of oligospermia. The mean SWE values and volume of the testes with varicocele were compared with the contralateral normal testes of the patients and the testes of healthy controls. RESULTS The mean SWE value of the left testes in groups A (4.77±1.16 kPa) and B (6.15±1.96 kPa) exceeded that of the healthy controls (3.79±0.94 kPa) (P<0.001). The mean SWE value of the left testes in group B (6.15±1.96 kPa) exceeded that of group A (4.77±1.16 kPa) (P=0.002). No correlation was observed between testicular stiffness and the grade of varicocele (r=0.102, P=0.423). CONCLUSION The testes with varicocele were stiffer than the contralateral testes and the testes of healthy controls, and SWE might play an auxiliary role to conventional ultrasonography in assessing pathologic alterations in the testis owing to varicocele.
Collapse
Affiliation(s)
- Onder Turna
- Department of Radiology, Istanbul Mehmet Akif Ersoy Cardiovascular and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | | |
Collapse
|
15
|
|
16
|
Bertolotto M, Muça M, Currò F, Bucci S, Rocher L, Cova MA. Multiparametric US for scrotal diseases. Abdom Radiol (NY) 2018; 43:899-917. [PMID: 29460046 DOI: 10.1007/s00261-018-1510-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Multiparametric US is increasingly recognized as a valuable problem-solving technique in scrotal pathologies. Compared to conventional Doppler modes, contrast-enhanced ultrasonography (CEUS) has higher sensitivity in assessing the presence or absence of flows, and to improve differentiation between poorly vascularized tumors and non-neoplastic, avascular lesions. Characterization of benign and malignant complex cysts is improved. In trauma patients, CEUS can help evaluating the viability of testicular parenchyma. In patients with severe epididymo-orchitis, it allows unequivocal assessment of post-inflammatory ischemic changes and abscess formation. CEUS does not add significantly to conventional Doppler modes in spermatic cord torsion. Attempt of differentiating benign and malignant tumors remains a research tool. In the clinical practice, elastography has a limited role for tumor characterization. The majority of malignant tumors are stiff at elastography, but they may display soft areas, or appear globally soft. A quantitative evaluation of testicular stiffness is feasible using shear-wave elastography. Potential clinical applications for elastographic modes could include work-up of infertile patients.
Collapse
Affiliation(s)
- Michele Bertolotto
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy.
| | - Matilda Muça
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy
| | - Francesca Currò
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy
| | - Stefano Bucci
- Department of Urology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy
| | - Laurence Rocher
- Department of Radiology, Hôpital de Bicêtre, 78 Avenue du General Lecters, 94270, Paris, France
| | - Maria Assunta Cova
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy
| |
Collapse
|