Gibran Yusuf – Joint Winner of Young Investigator Award Euroson 2015

Abstract

Methods ▼ Hematomas/tumours were identified from a database and retrospectively reviewed by experienced observers. All patients underwent testicular ultrasonography (US), by experienced observers, using high frequency transducers, employing standard techniques of MPUS combining grey-scale, colour Doppler, contrast enhanced ultrasound (CEUS) and strain elastography (SE). Features recorded were; size, location, echogenicity, colour Doppler signal, contrast-enhancement, elasticity score and strain ratio. Follow-up was recorded. Results ▼ 17 haematomas (right testis n=11, left testis n=6, maximum diameter range 5–28mm) in 8 patients (mean age 31 years, range 25-43 years) were analysed. Blunt trauma (n=7) and surgery (n=1) were preceding events. Greyscale sonography demonstrated well-defined, oval or round, predominantly hypoechoic and heterogeneous, peripherally (n=13) or centrally located (n=4). Three demonstrated CEUS enhancement of septations not seen on colour Doppler and 4 peripheral rim enhancement. Sixteen lesions had SE performed; mean strain ratio was 1.49 (range 0.41–2.77), elasticity score ≤3 (n=12) and 5 (n= 4). All lesions were confirmed benign on follow-up sonography. Retrospective analysis with similar size histologically proven tumours was performed (seminoma, Leydig cell tumours and non seminomatous germ cell tumours n=8, n=5, n=4 respectively). Demographics were similar in both groups (mean age 37 years, range 25-64). Grayscale imaging demonstrated predominantly subcapsular peripheral lesions which were predominantly hypoechoic or heterogeneous (n=16). The background testis was abnormal in (n=6) with microlithiasis the most common findings. On CEUS all lesions definitively showed enhancement and were found to be subjectively hard on SE (mean strain ratio 6.04, range 0.61-15).