Purpose: To describe elastographic features compared with CEUS, US-color-doppler and MRI findings in the diagnosis of testicular masses and the possible role the new technique could play.
Content organization: A review of the burden of this issue will be performed, followed by a review of the basic clinical tools and advanced instrumental tools available.
Afterward, both literature experience will be shown and it will be attempeted to address the discussion to the role of imaging techniques and elastography in this issue, together with our group’s experience. The latter is about 82 consecutive patients with testicular masses studied with elastography, CDUS, CEUS and MRI before surgery, which were composed in this way: seminomas N=40, 18 nonseminomatous testicular tumor, 8 Leydig cell tumor, and 2 non-Hodgkin lymphoma, 2epidermoid cyst, 6 necrosis/atrophy, 2 incarcerated inguinal hernia, 1 hematoma, suppurative epididymo-orchitis. Elastography was interpreted according to the Itoh’s colour map and the quantitative evaluation, or by using strain ratio, and CEUS studied both qualitatively and quantitatively the vascular behavior of the lesions, with MRI adding further information about morphological and vascular behavior.
Conclusion: Elastosonography and CEUS seem to be useful additional tools to differentiate testicular lesions where color-coded ultrasound reaches its limits. Therefore, differentiation of testicular lesions especially the smallest (<1 cm) may be significantly improved by means of multimodality imaging.
