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Rafailidis V, Robbie H, Konstantatou E, et al. Sonographic imaging of extra-testicular focal lesions: comparison of grey-scale, colour Doppler and contrast-enhanced ultrasound. Ultrasound. 2016;24(1):23-33doi: 10.1177/1742271X15626195.
Rafailidis, V., Robbie, H., Konstantatou, E., Huang, D. Y., Deganello, A., Sellars, M. E., Cantisani, V., Isidori, A. M., & Sidhu, P. S. (2016). Sonographic imaging of extra-testicular focal lesions: comparison of grey-scale, colour Doppler and contrast-enhanced ultrasound. Ultrasound (Leeds, England), 24(1), 23-33. https://doi.org/10.1177/1742271X15626195
Rafailidis, Vasileios, et al. "Sonographic imaging of extra-testicular focal lesions: comparison of grey-scale, colour Doppler and contrast-enhanced ultrasound." Ultrasound (Leeds, England) vol. 24,1 (2016): 23-33. doi: https://doi.org/10.1177/1742271X15626195
Rafailidis V, Robbie H, Konstantatou E, Huang DY, Deganello A, Sellars ME, Cantisani V, Isidori AM, Sidhu PS. Sonographic imaging of extra-testicular focal lesions: comparison of grey-scale, colour Doppler and contrast-enhanced ultrasound. Ultrasound. 2016 Feb;24(1):23-33. doi: 10.1177/1742271X15626195. Epub 2016 Jan 08. PMID: 27433272; PMCID: PMC4760612.
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Ultrasound. 2016 Feb;24(1):23-33. doi: 10.1177/1742271X15626195. Epub 2016 Jan 08.

Sonographic imaging of extra-testicular focal lesions: comparison of grey-scale, colour Doppler and contrast-enhanced ultrasound.

Ultrasound (Leeds, England)

Vasileios Rafailidis, Hasti Robbie, Eleni Konstantatou, Dean Y Huang, Annamaria Deganello, Maria E Sellars, Vito Cantisani, Andrea M Isidori, Paul S Sidhu

Affiliations

  1. King's College London, Department of Radiology, King's College Hospital, Denmark Hill, London, UK.
  2. Department of Radiology, Sapienza University of Rome, Italy.
  3. Department of Experimental Medicine, Sapienza University of Rome, Italy.

PMID: 27433272 PMCID: PMC4760612 DOI: 10.1177/1742271X15626195

Abstract

Extra-testicular lesions are usually benign but present with nonspecific grey-scale sonography findings. This study assesses conventional sonographic characteristics in the differentiation of extra-testicular tumoural from inflammatory lesions and whether contrast-enhanced ultrasound has a role. A retrospective database analysis was performed. All patients were examined by experienced sonographers employing standard techniques combining grey-scale, colour Doppler sonography and contrast-enhanced ultrasound. Features recorded were: clinical symptoms, size, location, echogenicity, colour Doppler sonography and contrast-enhanced ultrasound enhancement. Vascularity on colour Doppler sonography and contrast-enhanced ultrasound was graded and compared. The lesions were classified as tumoural or inflammatory. The Chi-square test was used to analyse the sonographic patterns and kappa coefficient to measure the agreement between colour Doppler sonography and contrast-enhanced ultrasound. A total of 30 lesions were reviewed (median diameter 12 mm, range 5-80 mm, median age 52 years, range 18-86 years), including 13/30 tumoural and 17/30 inflammatory lesions. Lesions were hypoechoic (n = 12), isoechoic (n = 6), hyperechoic (n = 2) or mixed (n = 10). Grey-scale characteristics of tumoural vs. inflammatory lesions differed significantly (P = 0.026). On colour Doppler sonography, lesions had no vessels (n = 16), 2-3 vessels (n = 10) and ≥4 vessels (n = 4). On contrast-enhanced ultrasound, lesions showed no vascularity (n = 17), perfusion similar to testis (n = 7) and higher (n = 6). All abscesses identified (n = 9) showed no vascularity on both colour Doppler sonography and contrast-enhanced ultrasound. There was good agreement between these techniques in evaluating vascularity (κ = 0.719) and no significant difference between colour Doppler sonography and contrast-enhanced ultrasound of tumoural vs. inflammatory lesions (P > 0.05). The grey-scale appearances of extra-testicular lesions are essential for characterisation. Colour Doppler sonography and contrast-enhanced ultrasound findings are not useful in that respect. Contrast-enhanced ultrasound is excellent in establishing absence of vascularity.

Keywords: Epididymis; contrast; inflammation; tumour; ultrasound

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