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.
常规超声检查，包括灰阶成像和彩色多普勒超声，在诊断阴囊病变中具有关键作用，但其特异性有限。历史上，实性局灶性睾丸异常常导致根治性睾丸切除术。本回顾性研究评估了对比增强超声和应变弹性成像在睾丸内局灶性异常检查中的应用，共分析了124例病例。研究强调了对比增强超声在检测所有恶性病例（包括彩色多普勒超声未能检测到血流的病例）中血管增强方面的卓越诊断能力，并突显了其在识别良性血管肿瘤特征性血流模式方面的潜力。当对比增强超声显示无增强时，可明确确认为良性病变。虽然单独使用应变弹性成像在区分良恶性病变方面无明显优势，但我们证明，在局灶性睾丸异常评估中结合使用对比增强超声和应变弹性成像，相比传统彩色多普勒超声可提高诊断性能指标。我们的研究结果强调了先进超声技术在临床实践中增强局灶性睾丸异常评估的作用，并可能有助于向保留睾丸的治疗策略转变。
Multiparametric Ultrasound for Focal Testicular Pathology: A Ten-Year Retrospective Review
肿瘤(癌症)患者之家