Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
Radiology. 2012 May;263(2):584-9. doi: 10.1148/radiol.12111732. Epub 2012 Mar 6.
To evaluate the feasibility of using real-time sonoelastography (RTE) for the differentiation and characterization of testicular lesions.
Institutional review board approval was obtained for this retrospective study, and the requirement to obtain informed consent was waived. Fifty patients (mean age, 42 years; age range, 18-81 years) with testicular lesions detected with gray-scale ultrasonography (US) and color and/or power Doppler US were evaluated with RTE between December 2004 and August 2010 to assess tissue elasticity of the testes. Stiff or "hard" lesions were suspected of being malignant. Testicular lesions with normal or decreased tissue stiffness ("soft" lesions) were considered benign. Findings from surgery and histopathologic examination were used as the reference standard in 34 cases, and findings from clinical and US follow-up were used as the reference standard in 16 cases. Sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic accuracy were calculated.
Thirty-four of the 50 lesions (68%) were testicular tumors and 16 (32%) were of nontumorous origin. RTE showed the presence of hard lesions in all cases of testicular tumors and three cases of nontumorous lesions. Four lesions with an uncertain diagnosis when tested with gray-scale US and color and/or power Doppler US alone were soft at RTE and showed nontumorous character at follow-up. RTE showed a sensitivity of 100%, a specificity of 81%, a negative predictive value of 100%, a positive predictive value of 92%, and an accuracy of 94% in the diagnosis of testicular tumors.
RTE demonstrated all testicular tumors as lesions with increased tissue stiffness. Because of its higher specificity, RTE can provide additional information in cases with indeterminate US findings.
评估实时超声弹性成像（RTE）用于睾丸病变的鉴别和特征分析的可行性。
本研究经机构审查委员会批准（同意），且豁免了获取知情同意的要求。回顾性分析 2004 年 12 月至 2010 年 8 月期间经灰阶超声、彩色及/或能量多普勒超声检查发现睾丸病变的 50 例患者（平均年龄 42 岁；年龄范围 18-81 岁）的 RTE 检查结果，以评估睾丸组织的弹性。僵硬或“硬”病变提示为恶性，而组织弹性正常或降低（“软”病变）的睾丸病变被认为是良性的。34 例以手术和组织病理学检查结果作为参考标准，16 例以临床和超声随访结果作为参考标准。计算了敏感性、特异性、阴性预测值、阳性预测值和诊断准确率。
50 个病变中有 34 个（68%）为睾丸肿瘤，16 个（32%）为非肿瘤性病变。RTE 显示所有睾丸肿瘤均为硬病变，3 例非肿瘤性病变也为硬病变。单独进行灰阶超声和彩色及/或能量多普勒超声检查不能明确诊断的 4 个病变，在 RTE 检查时表现为软病变，随访时显示为非肿瘤性病变。RTE 诊断睾丸肿瘤的敏感性为 100%，特异性为 81%，阴性预测值为 100%，阳性预测值为 92%，准确率为 94%。
RTE 显示所有睾丸肿瘤均为组织硬度增加的病变。由于其特异性较高，RTE 可为灰阶超声检查结果不确定的病例提供更多信息。
