Der Radiologe · 2018
[CEUS-Use in testicular pathologies].
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Marcon J, Trottmann M, Stief C G, Clevert D A
Аннотация
BACKGROUND: The work-up of scrotal diseases forms an essential part of daily work in urology. Sonography plays an important role in the diagnostic process, due to its wide availability and feasibility.
OBJECTIVES: Advantages of modern contrast-enhanced ultrasound (CEUS) are illustrated using examples of common testicular pathologies.
MATERIALS AND METHODS: Relevant studies regarding the application of CEUS on testicular pathologies are evaluated. PubMed and Medline were screened for reviews and clinical trials.
RESULTS: In the differentiation of benign and malignant testicular lesions, contrast medium uptake, e. g. can exclude a hemorrhagic testicular cyst. A differentiation between benign and malignant testicular lesions due to pure enhancement is currently not possible. Evaluation of testicular abscesses, infarctions and infections depends on the assessment of vascularization. Following a scrotal trauma, evaluation of enhancement can distinguish between vital and non-vital areas. A complete absence of perfusion may support the diagnosis of testicular torsion.
CONCLUSION: CEUS is a feasible instrument in the diagnostic work-up of testicular pathologies. Results from previous studies are promising. Regarding the application in cases of scrotal trauma, the method could play an essential role in the future. With regard to a classification of unclear testicular lesions, further studies with a larger number of patients are needed in order to confirm previously described perfusion patterns.
OBJECTIVES: Advantages of modern contrast-enhanced ultrasound (CEUS) are illustrated using examples of common testicular pathologies.
MATERIALS AND METHODS: Relevant studies regarding the application of CEUS on testicular pathologies are evaluated. PubMed and Medline were screened for reviews and clinical trials.
RESULTS: In the differentiation of benign and malignant testicular lesions, contrast medium uptake, e. g. can exclude a hemorrhagic testicular cyst. A differentiation between benign and malignant testicular lesions due to pure enhancement is currently not possible. Evaluation of testicular abscesses, infarctions and infections depends on the assessment of vascularization. Following a scrotal trauma, evaluation of enhancement can distinguish between vital and non-vital areas. A complete absence of perfusion may support the diagnosis of testicular torsion.
CONCLUSION: CEUS is a feasible instrument in the diagnostic work-up of testicular pathologies. Results from previous studies are promising. Regarding the application in cases of scrotal trauma, the method could play an essential role in the future. With regard to a classification of unclear testicular lesions, further studies with a larger number of patients are needed in order to confirm previously described perfusion patterns.