Department of Urology and Andrology, Peyronie's Care Center, Castelfidardo Clinical Analysis Center, Rome.
Section of Ultrasound Diagnostics, Department of Urology and Andrology, Castelfidardo Clinical Analysis Center, Rome.
Arch Ital Urol Androl. 2024 Oct 2;96(3):12690. doi: 10.4081/aiua.2024.12690.
B-mode ultrasound (US) medical imaging is very effective in localizing and describing Peyronie's disease (PD). Moreover, elastography is a new technique used to evaluate tissue elasticity to detect penile Peyronie's plaques that are not visible using standard B-mode US.
The main objective of this study was to evaluate the diagnostic efficacy of real-time elastography (RTE) in PD patients and to determine whether its combined use with standard US improved diagnostic accuracy. RTE is also known as strain elastography (SE). Additionally, this study aimed to assess whether RTE was useful for monitoring PD patients undergoing conservative treatment.
A group of 37 PD patients in the active phase was selected based on US examination showing isoechoic or hypo-isoechoic plaques, with or without associated hyperechoic or calcified plaque areas. All patients underwent traditional US combined with RTE before starting conservative treatment with antioxidants, during treatment and after treatment. After each examination with RTE, a specific "Strain Ratio"(SR) was used to identify the specific elasticity of the tissue.
Using B-mode US with RTE, we detected all 13 non-palpable penile plaques present in the 37 PD patients (100% of cases). Using only B-mode US, we detected only 8 of the 13 non-palpable plaques (61.5% of cases). The DI of the plaque decreased during and after treatment in all cases, indicating that RTE is effective for monitoring conservative PD treatment. A statistically significant correlation was found between the DI and plaque volume in all patients (p=0.002).
Our study has shown that the combination of US and RTE methods allowed for a more accurate diagnosis in PD patients.
B 型超声（US）医学成像在定位和描述 Peyronie 病（PD）方面非常有效。此外，弹性成像是一种新技术，用于评估组织弹性，以检测使用标准 B 型 US 不可见的阴茎 Peyronie 斑块。
本研究的主要目的是评估实时弹性成像（RTE）在 PD 患者中的诊断效能，并确定其与标准 US 联合使用是否提高了诊断准确性。RTE 也称为应变成像（SE）。此外，本研究旨在评估 RTE 是否有助于监测接受保守治疗的 PD 患者。
根据 US 检查显示等回声或低回声斑块，伴或不伴相关高回声或钙化斑块区域，选择一组 37 例处于活动期的 PD 患者。所有患者在开始抗氧化剂保守治疗前、治疗期间和治疗后均接受传统 US 联合 RTE 检查。每次 RTE 检查后，使用特定的“应变比”（SR）来识别组织的特定弹性。
使用 RTE 的 B 型 US 检测到 37 例 PD 患者中所有 13 处不可触及的阴茎斑块（100%的病例）。仅使用 B 型 US，我们仅检测到 13 处不可触及斑块中的 8 处（61.5%的病例）。在所有病例中，斑块的 DI 在治疗期间和治疗后均降低，表明 RTE 对监测保守 PD 治疗有效。在所有患者中，DI 与斑块体积之间存在统计学显著相关性（p=0.002）。
我们的研究表明，US 和 RTE 方法的联合使用可提高 PD 患者的诊断准确性。
