Huang Dean Y, Alsadiq Majed, Yusuf Gibran T, Deganello Annamaria, Sellars Maria E, Sidhu Paul S
Department of Clinical Radiology, King's College Hospital, London SE5 9RS, UK.
Department of Imaging Sciences, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London SE1 7EH, UK.
Cancers (Basel). 2024 Jun 24;16(13):2309. doi: 10.3390/cancers16132309.
Conventional ultrasonography (US), including greyscale imaging and colour Doppler US (CDUS), is pivotal for diagnosing scrotal pathologies, but it has limited specificity. Historically, solid focal testicular abnormalities often led to radical orchidectomy. This retrospective study evaluated the utilisation of contrast-enhanced ultrasound (CEUS) and strain elastography (SE) in investigating intratesticular focal abnormalities. A total of 124 cases were analysed. This study underscored the superior diagnostic capabilities of CEUS in detecting vascular enhancement in all malignant cases, even those with undetectable vascularity by CDUS. It also highlighted the potential of CEUS in identifying distinctive vascular patterns in benign vascular tumours. Definitive confirmation of benignity could be obtained when the absence of enhancement was demonstrated on CEUS. While SE alone offered no distinctive advantage in differentiating between benign and malignant pathologies, we demonstrated that incorporating a combination of CEUS and SE into the evaluation of focal testicular abnormalities could improve diagnostic performance metrics over conventional CDUS. Our findings underscore the role of advanced ultrasound techniques in enhancing the evaluation of focal testicular abnormalities in clinical practice and could aid a shift towards testis-sparing management strategies.
传统超声检查（US），包括灰阶成像和彩色多普勒超声（CDUS），对于诊断阴囊疾病至关重要，但特异性有限。从历史上看，实性局灶性睾丸异常往往导致根治性睾丸切除术。这项回顾性研究评估了超声造影（CEUS）和应变弹性成像（SE）在研究睾丸内局灶性异常中的应用。共分析了124例病例。该研究强调了CEUS在检测所有恶性病例中的血管增强方面具有卓越的诊断能力，即使是那些CDUS检测不到血管的病例。它还突出了CEUS在识别良性血管肿瘤独特血管模式方面的潜力。当CEUS显示无增强时，可以获得良性的确切确认。虽然单独的SE在区分良性和恶性病变方面没有明显优势，但我们证明，将CEUS和SE结合用于评估局灶性睾丸异常可以比传统CDUS提高诊断性能指标。我们的研究结果强调了先进超声技术在临床实践中加强对局灶性睾丸异常评估的作用，并有助于向保留睾丸的管理策略转变。
