Application Of Multimodality Ultrasound Imaging In Differential Diagnosis Of Testicular Mass Lesions

Part one Application of ultrasound in differential diagnosis of testicular mass lesionsObjective To explore the value of ultrasound(US)and color doppler flow image(CDFI)in the differential diagnosis of benign and malignant testicular mass lesions.Methods Two-dimensional and color doppler ultrasound features of 118 cases of testicular mass lesions were analyzed in the Ultrasound Department of the Second Hospital of Lanzhou University and pathologically confirmed or clinically treated were retrospectively analyzed.Preliminary identification of benign and malignant tumors by comparing ultrasound features of testicular masses of different natures.Results In this study,the number of lesions,the extent of the lesion(focal /diffuse),the type of echo,the boundary,the shape,the presence or absence of cystic changes,blood flow,whether with microlithiasis,side,uniformity,etc.Analysis of 10 characteristics,the results of the study showed that the testicular benign and malignant masses have statistically significant differences in the boundaries,appearance,blood flow,and whether with microlithiasis(P <0.05),There were no significant differences in the number of lesions,the extent of the lesions(focal / diffuse),the type of echo,the presence or absence of cystic changes,side,and uniformity(P> 0.05).Conclusion US and CDFI is of great value in the differential diagnosis of benign and malignant testicular masses.Part two The value of contrast-enhanced ultrasound in the differential diagnosis of testicular mass lesionsObjective To explore the value of different enhancement features of contrast enhanced ultrasound(CEUS)in the differential diagnosis of benign and malignanttesticular mass lesions.Methods A retrospective analysis was performed on the CEUS characteristics of 81 testicular mass lesions were examined by CEUS in the Ultrasound Department of the second hospital of Lanzhou University with postoperative pathological confirmation or clinical treatment follow-up.The benign and malignant tumors were identified,and CEUS characteristics were analyzed by multivariate binary logistic regression to predict the malignant risk of testicular mass lesions.Results The CEUS characteristics of benign and malignant testicular lesions are generally different.This study analyzed six CEUS features including the enhancement boundary,initial growth rate,lesion size,enhancement uniformity,enhancement level,and clearance rate of testicular mass lesions.The difference in the enhancement boundary,the initial growth rate,and the lesion size after enhancement were statistically significant(P<0.05),and there were no significant differences in enhancement uniformity,enhancement level,and clearance speed(P> 0.05).At the same time,the above 6 CEUS features were subjected to multivariate binary logistic regression analysis and 3 CEUS features related to malignant testicular lesions were screened out.The relative malignant risk levels from high to low are: the boundary of enhancement is unclear,fast speed into testicular lesions,the size of the lesion increases after enhancement.Conclusion CEUS has important value in distinguishing benign from malignant testicular masses.Part three Preliminary application of ultrasound elastography in the diagnosis of testicular mass lesionsObjective To explore the value of ultrasounic elastography(UE)in the differential diagnosis of benign and malignant testicular mass lesions.Methods A retrospective analysis was performed on the ultrasound examination findings of the Ultrasound Department of the Second Hospital of Lanzhou University,and then the ultrasound elasticity examination was performed and the elasticity was graded.The ultrasound elasticity of 75 cases of testicular mass lesions that were confirmed by pathology or clinical treatment.The sensitivity,specificity,and accuracy of the differential classification of benign and malignant mass lesions of different nature and the elastography classification in differential diagnosis were compared.Results Ultrasound elasticity classification of benign testicular lesions is mainly grade 1,2;Ultrasound elasticity classification of testicular malignant lesions is mainly grade 3 to 5.Ultrasound elastography has a sensitivity of 97.4%,a specificity of66.7%,and an accuracy of 82.7%.Conclusion Ultrasound elastography is of great value in distinguishing benign from malignant testicular masses.