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A preliminary study of shear-wave elastography for the evaluation of varicocele in adolescents and young adults

Ultrasonography 2022년 41권 1호 p.131 ~ 139
류영진, 최영훈, 김지영, 천정은, 김우선, 김인원, 박지은, 임영재, 박관진,
소속 상세정보
류영진 ( Ryu Young-Jin ) - Seoul National University Bundang Hospital Department of Radiology
최영훈 ( Choi Young-Hun ) - Seoul National University College of Medicine Department of Radiology
김지영 ( Kim Ji-Young ) - Seoul National University Bundang Hospital Department of Radiology
천정은 ( Cheon Jung-Eun ) - Seoul National University College of Medicine Department of Radiology
김우선 ( Kim Woo-Sun ) - Seoul National University College of Medicine Department of Radiology
김인원 ( Kim In-One ) - Seoul National University College of Medicine Department of Radiology
박지은 ( Park Ji-Eun ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
임영재 ( Im Young-Jae ) - Seoul National University College of Medicine Department of Urology
박관진 ( Park Kwan-Jin ) - Seoul National University College of Medicine Department of Urology

Abstract


Purpose: The purpose of this study was to use shear-wave elastography (SWE) to assess testicular stiffness changes during the Valsalva maneuver in adolescents and young adults with varicocele, to compare these changes according to clinical severity, and to evaluate the role of SWE in the diagnosis of varicocele.

Methods: This study included patients undergoing testicular ultrasonography for the diagnosis of varicocele or for post-varicocelectomy follow-up between June 2016 and February 2017. Fifty-four testicles of 27 consecutive patients (mean age, 15.9 years) were classified by clinical grade (grade 0-3). Using SWE, mean testicular stiffness (Emean) was measured at rest and during the Valsalva maneuver. The correlations between multiple ultrasonographic parameters (volume asymmetry, Emean at rest, and absolute and percentage changes in Emean during the Valsalva maneuver) and clinical grade were assessed using the Spearman correlation test.

Results: The Emean at rest was similar across clinical grades. During the Valsalva maneuver, increased testicular stiffness was frequently observed in patients with grade 2 or 3 varicocele but rarely observed in those with grade 0 or 1 varicocele. The changes in Emean were positively correlated with the clinical grade (all P<0.001), whereas the Emean at rest and volume asymmetry were not (all P>0.05).

Conclusion: A transient, reversible increase in testicular stiffness during the Valsalva maneuver was observed in adolescents with high-grade varicocele, and the degree of stiffness change was correlated with the clinical grade. Stiffness change identified using SWE during the Valsalva maneuver is a potential surrogate indicator of venous congestion.

키워드

Shear-wave elastography; Varicocele; Adolescents; Valsalva maneuver; Testicular stiffness

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