Marcon J, Trottmann M, Rübenthaler J, D'Anastasi M, Stief C G, Reiser M F, Clevert D A
Department of Urology, Ludwig-Maximilians-University Munich - Campus Grosshadern, Munich, Germany.
Department of Clinical Radiology, Ludwig-Maximilians-University Munich - Campus Grosshadern, Munich, Germany.
Clin Hemorheol Microcirc. 2016;64(3):447-456. doi: 10.3233/CH-168115.
Shear wave elastography (SWE) and its derivative Supersonic Shear Imaging (SSI) are newer techniques for the determination of tissue elasticity by measuring the velocity of generated shear waves (SWV), which correlates positively with tissue stiffness.The techniques are integrated into many modern ultrasound systems and have been examined in the evaluation of viscoelastic properties of different organ systems. Two-dimensional shear wave elastography (2D SWE) of the testes has been found to be a useful tool in recent studies which included the determination of standard values in healthy volunteers. Three-dimensional shear wave elastography (3D SWE) is the latest development in elastography and is made possible by generation of a multiplanar three-dimensional map via volumetric acquisition with a special ultrasound transducer. This technique allows the assessment of tissue elasticity in a three-dimensional, fully accessible organ map.The aim of this preliminary study was to both evaluate the feasibility of 3D SWE and to compare 2D and 3D SWE standard values in the testes of healthy subjects.
We examined the testes of healthy male volunteers (n = 32) with a mean age of 51.06±17.75 years (range 25-77 years) by B-mode ultrasound, 2D and 3D SWE techniques in September of 2016. Volunteers with a history of testicular pathologies were excluded. For all imaging procedures the SL15-4 linear transducer (bandwidth 4-15 MHz) as well as the SLV16-4 volumetric probe (bandwidth 4-16 MHz) of the Aixplorer® ultrasound device (SuperSonic Imagine, Aix-en-Provence, France) were used. Seven regions of interest (ROI, Q-Box®) within the testes were evaluated for SWV using both procedures. SWV values were described in m/s. Results were statistically evaluated using univariateanalysis.
Mean SWV values were 1.05 m/s for the 2D SWE and 1.12 m/s for the 3D SWE.Comparisons of local areas delivered no statistically significant differences (p = 0.11 to p = 0.66), except for the region in the central portion in the superior part of the coronal plane (p = 0.03). Testicular volume was significanty higher by a mean of 1.72 ml when measured with 3D SWE (p = 0.001).
3D SWE proved to be a feasible diagnostic tool in the assessment of testicular tissue, providing the examiner with a fully accessible three-dimensional map in a multiplanar or multislice view. With this technique a more precise testicular imaging - especially if combined with the display of tissue stiffness in SWE - is available and therefore could improve the diagnostic work-up of scrotal masses or the routine investigation of infertile men. Further studies for a better understanding in the context of various testicular pathologies will be required.
剪切波弹性成像（SWE）及其衍生技术超音速剪切成像（SSI）是通过测量所产生剪切波的速度（SWV）来测定组织弹性的较新技术，该速度与组织硬度呈正相关。这些技术已被整合到许多现代超声系统中，并已用于评估不同器官系统的粘弹性特性。在最近的研究中，睾丸的二维剪切波弹性成像（2D SWE）已被证明是一种有用的工具，其中包括确定健康志愿者的标准值。三维剪切波弹性成像（3D SWE）是弹性成像的最新进展，通过使用特殊超声换能器进行容积采集生成多平面三维图得以实现。该技术允许在三维、完全可及的器官图中评估组织弹性。这项初步研究的目的是评估3D SWE的可行性，并比较健康受试者睾丸中2D和3D SWE的标准值。
2016年9月，我们使用B超、2D和3D SWE技术检查了平均年龄为51.06±17.75岁（范围25 - 77岁）的健康男性志愿者（n = 32）的睾丸。排除有睾丸病变病史的志愿者。对于所有成像程序，使用了Aixplorer®超声设备（法国普罗旺斯艾克斯市的SuperSonic Imagine公司）的SL15 - 4线性换能器（带宽4 - 15MHz）以及SLV16 - 4容积探头（带宽4 - 16MHz）。使用这两种程序对睾丸内的七个感兴趣区域（ROI，Q - Box®）进行SWV评估。SWV值以m/s为单位描述。结果采用单变量分析进行统计学评估。
2D SWE的平均SWV值为1.05m/s，3D SWE的平均SWV值为1.12m/s。除冠状面上部中央部分区域外（p = 0.03），局部区域的比较未显示出统计学上的显著差异（p = 0.11至p = 0.66）。用3D SWE测量时，睾丸体积平均显著高出1.72ml（p = 0.001）。
3D SWE被证明是评估睾丸组织的一种可行的诊断工具，为检查者提供了多平面或多层视图的完全可及的三维图。通过这项技术，可以获得更精确的睾丸成像——特别是与SWE中组织硬度显示相结合时——因此可以改善阴囊肿块的诊断检查或不育男性的常规检查。需要进一步开展研究以更好地了解各种睾丸病变情况下的情况。
