Application of Quasistatic Ultrasound Elastography for Examination of Scrotal Lesions.

Abstract

The aims of this study were to investigate the value of applying quasistatic ultrasound elastography for examination of scrotal lesions, to investigate the features of normal testes on quasistatic elastography, and to establish whether testicular and epididymal lesions had specific quasistatic elastographic features. We screened 1073 patients who underwent color Doppler sonographic examinations of the testes and epididymides in our hospital and performed quasistatic elastography to evaluate their sonographic features. Measurement data were expressed as mean ± SD. For intergroup comparisons, we used paired t tests and independent-samples t tests, with P < .05 considered significant. Quasistatic elastography did not reveal any testicular or epididymal abnormalities in 625 cases. Seven cases showed testicular torsion; 3 cases showed testicular space-occupying lesions (1 case each of a testicular teratoma, testicular seminoma, and testicular endodermal sinus tumor); 176 cases showed epididymal lesions (138 cases of caudal epididymal inflammatory masses, 37 cases of caput epididymal cysts, and 1 case of an epididymal lymphangioma); and 262 cases showed varicocele. The normal testicular elastographic appearance showed a 3-ring structure: red surrounding bands with a blue edge region and a green central area. The stiffness in cases of testicular torsion, testicular space-occupying lesions, and epididymal lesions was increased, whereas caput epididymal cysts of different diameters appeared either as green, blue-green-red, or "scooped out." Elastographic results for patients with varicocele were not different from those for normal testes. Quasistatic elastography can reflect the relative stiffness of the testis and its surrounding tissues, thus providing a novel, reliable, convenient, and noninvasive method for clinical detection of testicular stiffness and related pathologic changes.