Korean J Radiol.  2012 Dec;13(6):820-822. 10.3348/kjr.2012.13.6.820.

Shear-Wave Elastography of Segmental Infarction of the Testis

• Kantarci F
• Cebi Olgun D
• Mihmanli I

• KMID: 1397516
• DOI: http://doi.org/10.3348/kjr.2012.13.6.820

Abstract

Segmental testicular infarction (STI) is a rare cause of acute scrotum. The spectrum of findings on gray-scale and color Doppler ultrasonography differ depending on the time between the onset of testicular pain and the ultrasonography examination. We are not aware of the usefulness of shear-wave elastography for the diagnosis of STI. We report the shear-wave elastography features in a case of STI and discuss the role of this diagnostic modality in the differential diagnosis.

Keyword

Testis; Infarction; Ultrasonography; Sonoelastography; Doppler ultrasonography

MeSH Terms

Acute Pain/etiology
Adult
Diagnosis, Differential
*Elasticity Imaging Techniques
Humans
Infarction/complications/*ultrasonography
Male
Scrotum/ultrasonography
Testis/*blood supply
Ultrasonography, Doppler, Color

Figure

• 

  Fig. 1 Segmental testicular infarction in 35-year-old man. A. Power Doppler Ultrasonography (US) at initial presentation demonstrates absent flow in upper pole of left testis with perilesional hypervascularity. B. Gray-scale US of upper pole of left testis shows inconspicuous isohyperechoic almost round area (white arrows) with softer central part (asterisk) on shear-wave elastography (mean stiffness, 1.7 kPa). C. Gadolinium-enhanced magnetic resonance imaging reveals avascular area with perilesional hypervascularity (arrow). D, E. Follow-up US examinations were obtained 10 days later. Power Doppler US examination (D) demonstrates presence of intralesional vascularity (white arrow). Gray-scale and shear-wave elastography examinations (E) demonstrate that lesion is ill-defined but has wedge shape (white arrows) on gray-scale component of image. Elastography depicts more conspicuous triangular wedge shaped area corresponding to infarcted testicular lobule. Note that lesion is stiffer than normal testicular parenchyma.

Reference

1. Bilagi P, Sriprasad S, Clarke JL, Sellars ME, Muir GH, Sidhu PS. Clinical and ultrasound features of segmental testicular infarction: six-year experience from a single centre. Eur Radiol. 2007. 17:2810–2818.

2. Secil M, Kocyigit A, Aslan G, Kefi A, Ozdemir I, Tuna B, et al. Segmental testicular infarction as a complication of varicocelectomy: sonographic findings. J Clin Ultrasound. 2006. 34:143–145.

3. Fernández-Pérez GC, Tardáguila FM, Velasco M, Rivas C, Dos Santos J, Cambronero J, et al. Radiologic findings of segmental testicular infarction. AJR Am J Roentgenol. 2005. 184:1587–1593.

4. Kim HK, Goske MJ, Bove KE, Minovich E. Segmental testicular infarction in a young man simulating a testicular tumor. Pediatr Radiol. 2009. 39:400–402.

5. Athanasiou A, Tardivon A, Tanter M, Sigal-Zafrani B, Bercoff J, Deffieux T, et al. Breast lesions: quantitative elastography with supersonic shear imaging--preliminary results. Radiology. 2010. 256:297–303.

6. Garra BS. Imaging and estimation of tissue elasticity by ultrasound. Ultrasound Q. 2007. 23:255–268.

7. Goddi A, Sacchi A, Magistretti G, Almolla J, Salvadore M. Real-time tissue elastography for testicular lesion assessment. Eur Radiol. 2011. [Epub ahead of print].

8. Bertolotto M, Derchi LE, Sidhu PS, Serafini G, Valentino M, Grenier N, et al. Acute segmental testicular infarction at contrast-enhanced ultrasound: early features and changes during follow-up. AJR Am J Roentgenol. 2011. 196:834–841.

9. Sriprasad S, Kooiman GG, Muir GH, Sidhu PS. Acute segmental testicular infarction: differentiation from tumour using high frequency colour Doppler ultrasound. Br J Radiol. 2001. 74:965–967.

10. Horstman WG, Melson GL, Middleton WD, Andriole GL. Testicular tumors: findings with color Doppler US. Radiology. 1992. 185:733–737.

11. Sidhu PS, Sriprasad S, Bushby LH, Sellars ME, Muir GH. Impalpable testis cancer. BJU Int. 2004. 93:888.