Shear Wave Sonoelastography Findings of Testicles in Chronic Kidney Disease Patients Who Undergo Hemodialysis

Application value of real-time shear wave elastography for quantitative evaluation of chronic kidney disease in pediatric patients

OBJECTIVE

To evaluate the effectiveness of real-time shear wave elastography (SWE) in quantitative evaluation of chronic kidney disease (CKD) in pediatric patients.

METHODS

SWE was conducted on 58 pediatric patients with CKD (CKD group) and 70 healthy volunteers (Control group). Computer-assisted quantitative analysis was utilized to determine the percentage of interstitial fibrosis (IF) in images from the CKD group, categorizing them into mild, moderate, and severe groups according to IF% values. The differences in Young's modulus (YM) and estimated Glomerular Filtration Rate (eGFR) between the renal cortex and medulla in these groups were compared. Additionally, the relationships between YM and IF% as well as YM and eGFR, were analyzed.

RESULTS

The YM values in right lower pole cortex and medulla of the CKD group were significantly higher than those in the control group (all P < 0.05). Significant differences were observed in eGFR among mild, moderate, and severe CKD patients (F = 40.882). YM demonstrated a correlation with eGFR in both the renal cortex and medulla (r = -0.329, P = 0.012; r = 0.417, P = 0.001). YM values increased with the severity of renal interstitial fibrosis in a pronounced trend across groups (F = 109.962, F = 72.950, all P < 0.001). Additionally, YM correlated with IF% in both the renal cortex and medulla (r = 0.362, P = 0.006; r = 0.483, P < 0.001). The optimal cut-off value of renal cortex YM for distinguishing between CKD and control group was 4.05 kPa.

CONCLUSION

SWE enables quantitative assessment of kidney YM values, revealing significantly higher values in children with CKD compared to healthy individuals. YM is correlated with the severity of renal interstitial fibrosis, thereby establishing SWE as a valuable non-invasive tool for quantitative evaluation of pediatric CKD.

Shear-wave elastography of the testicle: potential role of the stiffness value in various common testicular diseases

AIM

To assess the value and efficacy of real-time shear-wave elastography (SWE) of normal testicular parenchyma and various common testicular diseases in clinical practice.

MATERIALS AND METHODS

SWE was undertaken in 338 patients (mean age: 43.2±17.2 years, range 17-78 years) comprising normal testicles (n = 358), testicular microlithiasis (n = 40), and various testicular diseases (n = 208) and the stiffness was recorded. The final diagnosis was correlated with the clinical context, long-term follow-up, or histopathology. Statistical evaluation was performed to provide a stiffness threshold for pathological diagnosis.

RESULTS

The mean size of testicular lesions was 2.6±1.5 cm (range: 10-42 mm). The mean Young's modulus value for normal testis was recorded at 4.55±2.54 kPa. Whatever the stage of microlithiasis, a higher statistically significant stiffness value was recorded. For acute orchitis, the mean stiffness value was slightly higher, but not statistically significantly. The testicular tumoural processes presented a median stiffness value of 21.02 kPa with a cut-off of 16.1 kPa. Fibrosis presented the highest median stiffness value of 30.03 kPa with a cut-off of 26.3 kPa. By analysing the distribution of the different pathological groups, the difference was statistically significant between fibrosis and tumoural processes (p = 0.001).

CONCLUSION

SWE is a feasible technique in the exploration of the testicular parenchyma. SWE values can be used to differentiate testicular fibrosis from a tumoural process with confidence.

Comparison of Tissue Stiffness Using Shear Wave Elastography in Men with Normal Testicular Tissue, Testicular Microlithiasis and Testicular Cancer

Objectives

To compare elastography measurements in men with normal testicular tissue, testicular microlithiasis and testicular cancer.

Methods

A total of 248 consecutive patients were included. All men provided written informed consent. Testicular stiffness was assessed using shear wave elastography (SWE). Three SWE velocity measurements were assessed in each testicle. The patients were divided into three groups; men with normal testicular tissue (n=130), men with testicular microlithiasis (n=99) and men with testicular cancer (n=19).

Results

We found a higher mean velocity in the group of patients with testicular cancer (1.92 m/s (95% CI 1.82-2.03)) compared to both the group with normal tissue (0.76 m/s (95% CI: 0.75-0.78)) (p<0.001) and the group with testicular microlithiasis 0.79 m/s (95% CI: 0.77-0.81) (p<0.001).

Conclusion

The presence of testicular microlithiasis increased stiffness slightly, but within the range of variation in normal testicles. Increased stiffness may indicate testicular malignancy in testicular lesions. Ultrasound elastography could be a very useful tool when investigating scrotum.