Ultrasonography.
2022 Jan;41(1):131-139. 10.14366/usg.20213.
A preliminary study of shear-wave elastography for the evaluation of varicocele in adolescents and young adults
- Affiliations
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- 1Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
- 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- 3Department of Radiology, Seoul National University Hospital, Seoul, Korea
- 4Department of Radiology, Ajou University Medical Center, Suwon, Korea
- 5Division of Pediatric Urology, Seoul National University Children’s Hospital, Seoul, Korea
- 6Department of Urology, Seoul National University College of Medicine, Seoul, Korea
- KMID: 2523425
- DOI: http://doi.org/10.14366/usg.20213
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.
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