Beşler Muhammed Said, Gökhan Muhammet Batuhan, Ölçücüoğlu Esin, Özdemir Fatma Ayça Edis
Department of Radiology, Ankara City Hospital, Ankara, Turkey.
Andrologia. 2022 Dec;54(11):e14565. doi: 10.1111/and.14565. Epub 2022 Aug 16.
The aim of this study was to assess the utility of shear wave elastography in the follow-up of testicular detorsion, evaluate long-term outcomes, and explore its relationship with parameters such as tissue stiffness values, pain duration, and torsion type. Elastography examinations were independently performed by two radiologists to evaluate patients who presented to our hospital for follow-up after being diagnosed with testicular torsion and age-matched controls. Inter-observer variability of the mean testicular tissue elasticity was excellent (Intraclass correlation coefficient: 0.939, p < 0.001). Median time between testicular detorsion and follow-up ultrasound examination was 18 months (range, 11-36 months). Torsion side, torsion degree, and pain duration were recorded, and testicular volumes were calculated. The study population comprised 24 patients (48 testes) with a mean age of 21.1 ± 7.8 years. The mean testicular volume was measured as 12.3 ± 5.4 ml for the testicular salvage group, 13.9 ± 3.8 ml for the contralateral testes, and 13.7 ± 2.7 ml for the control group (p = 0.553). The mean testicular speed mode values were higher in the testicular salvage group (1.34 ± 1.21 m/s) compared with the contralateral testes group (1.00 ± 0.08 m/s), and the control group (1.01 ± 0.06 m/s), however there was no statistically significant difference between the three groups (p = 0.861). While testicular atrophy was detected in three patients, an intraparenchymal wedge-shaped focal hypoechoic area developed after torsion in a further three patients. The elastography examination for focal hypoechoic areas revealed an increase or decrease in tissue stiffness compared to the normal parenchyma. The tissue stiffness values of the testicular salvage group were higher in complete torsion compared to incomplete torsion. The elastography method contributes to other imaging methods in distinguishing focal lesion areas that can be seen after testicular torsion from malignant conditions. Elastography presents as a feasible and practical complementary modality for the follow-up of testicular salvage after torsion.
本研究的目的是评估剪切波弹性成像在睾丸扭转随访中的应用价值，评估长期预后，并探讨其与组织硬度值、疼痛持续时间和扭转类型等参数之间的关系。由两名放射科医生独立进行弹性成像检查，以评估因睾丸扭转前来我院随访的患者以及年龄匹配的对照组。睾丸组织平均弹性的观察者间变异性极佳（组内相关系数：0.939，p < 0.001）。睾丸扭转与随访超声检查之间的中位时间为18个月（范围11 - 36个月）。记录扭转侧、扭转程度和疼痛持续时间，并计算睾丸体积。研究人群包括24例患者（48个睾丸），平均年龄为21.1 ± 7.8岁。睾丸挽救组的平均睾丸体积为12.3 ± 5.4 ml，对侧睾丸为13.9 ± 3.8 ml，对照组为13.7 ± 2.7 ml（p = 0.553）。睾丸挽救组的平均睾丸速度模式值（1.34 ± 1.21 m/s）高于对侧睾丸组（1.00 ± 0.08 m/s）和对照组（1.01 ± 0.06 m/s），但三组之间无统计学显著差异（p = 0.861）。3例患者检测到睾丸萎缩，另有3例患者扭转后实质内出现楔形局灶性低回声区。对局灶性低回声区的弹性成像检查显示，与正常实质相比，组织硬度增加或降低。与不完全扭转相比，完全扭转时睾丸挽救组的组织硬度值更高。弹性成像方法有助于其他成像方法区分睾丸扭转后可见的局灶性病变区域与恶性病变。弹性成像对于睾丸扭转后挽救情况的随访是一种可行且实用的补充方式。
