The efficacy of shear-wave elastography – performed simultaneously with Doppler sonography – for differentiating between testicular torsion and epididymo-orchitis

Abstract

Background and aimShear-wave elastography (SWE) is a noninvasive ultrasonographic procedure that uses sound waves to measure tissue elasticity. Testicular torsion (TT) is an important emergency condition that is frequently misdiagnosed as epididymo-orchitis (EO). Doppler sonography (DS) is currently associated with false-positive and false-negative results owing to a variety of reasons, although its sensitivity and specificity for the differential diagnosis of TT and EO remain high. The aim of this study was to determine the efficacy of SWE performed simultaneously with DS for differentiating between TT and EO. Materials and methodsThe study included 32 male Wistar albino rats weighing 300–350 g. The rats were randomly divided into the following groups of 8 each: 1. Control group; 2. Sham group; 3. TT group; 4. EO group. The TT group was divided into subgroup 1 (SE and DS performed 1 h after inducing TT) and subgroup 2 (SE and DS performed 24 h after inducing TT). Scrotal SWE and DS were performed simultaneously in all the rats. ResultsThere were significant differences in velocity and stiffness between the control group and TT subgroup 1 (P < 0.005). Similarly, there were significant differences in velocity and stiffness between the sham group and TT subgroup 2 (P < 0.005), and between TT subgroup 2 and the EO group (P < 0.005). ROC curves plotted for velocity and stiffness in TT yielded cutoff values of 2.21 ms and 14.09 kPa, respectively. ConclusionWhen simultaneously performing SWE and DS for the differential diagnosis of TT and EO, high testicular velocity and stiffness values can be considered indicative of TT. Based on the present findings, we think that routine simultaneous use of SWE and DS, rather than DS only, could reduce the rates of false-negative and false-positive TT results.