[CEUS-Use in testicular pathologies].

BACKGROUND

The work-up of scrotal diseases forms an essential part of daily work in urology. Sonography plays an important role in the diagnostic process, due to its wide availability and feasibility.

OBJECTIVES

Advantages of modern contrast-enhanced ultrasound (CEUS) are illustrated using examples of common testicular pathologies.

MATERIALS AND METHODS

Relevant studies regarding the application of CEUS on testicular pathologies are evaluated. PubMed and Medline were screened for reviews and clinical trials.

RESULTS

In the differentiation of benign and malignant testicular lesions, contrast medium uptake, e. g. can exclude a hemorrhagic testicular cyst. A differentiation between benign and malignant testicular lesions due to pure enhancement is currently not possible. Evaluation of testicular abscesses, infarctions and infections depends on the assessment of vascularization. Following a scrotal trauma, evaluation of enhancement can distinguish between vital and non-vital areas. A complete absence of perfusion may support the diagnosis of testicular torsion.

CONCLUSION

CEUS is a feasible instrument in the diagnostic work-up of testicular pathologies. Results from previous studies are promising. Regarding the application in cases of scrotal trauma, the method could play an essential role in the future. With regard to a classification of unclear testicular lesions, further studies with a larger number of patients are needed in order to confirm previously described perfusion patterns.