Elasto-sonography of the testis: preliminary experience.

Objectives: We report our experience in elastosonography, a new developed ultrasonographic diagnostic dynamic technique used to provide an estimation about tissue stiffness.

Methods: 41 patients who presented with scrotal pain, painless enlargement of the scrotum or testicular nodules and infertility were submitted to ultrasound examination (US), color Doppler ultrasonography (CDU), elastosonography examination (E). During ultrasonography examination we obtained conventional B-mode images. Lesion size was defined by the major diameter The color Doppler examination was performed to evaluate the vascular pattern. Subsequently we obtained elasticity images, with the patient in supine position. We used Hi Vision 8500 (Hitachi-Tokyo, Japan) ultrasonography machine with SonoElastography imaging option and we scanned with 7,5 MHz linear probe. To obtain images that were appropriate for analysis, we applied the probe with only light pressure, which we defined as a level of pressure that maintained contact with the skin and permitted imaging conditions for which the association between pressure and strain was essentially proportional.

Results: In 38 cases elastosonography confirmed the US and CDU findings. In the remaining 3 cases it allowed a better characterization of 2 small benign tumors and of an intratesticular haematoma.

Conclusion: In our preliminary experience elastosonography can provide additional informations by an higher definition in those cases where there are solid testicular lesions smaller than 10 mm. Infact elastosonography resulted helpful in the determination of 2 small lesions diagnosticated after surgery as Sertoli tumor and adenomatoid tumor of the testis, respectively in a third case the elastosonography identified an intraparenchimal hematoma (confirmed after surgical exploration )in the differential diagnosis with a solid tumor. Further systematic experience is needed for better characterization of testicular lesions with this newly developed technique.