Abstract：
OBJECTIVE: Ultrasound (US) is the primary imaging modality when a testicular tumor is suspected. Superb microvascular imaging (SMI) is a novel, highly sensitive Doppler technique that allows quantification of flow signals by determination of the Vascular Index (VI). The aim of the present study is to investigate the diagnostic significance of the SMI-derived VI in normal testicular tissue and testicular cancer.
METHODS: This retrospective analysis included patients who underwent testicular US in our department from 2018 to 2022. Inclusion criteria were: i) sufficient image quality of the stored images, ii) US with standardized SMI-default setting (colour gain of 44 ± 5), iii) patient age ≥ 18 years, and iv) normal testicular findings or testicular tumor with histopathological workup. US examinations were performed as part of clinical routine using a high-end ultrasound system (Aplio i800/i900, Canon Medical Systems Corporation, Tochigi, Japan). Statistical analysis included Chi-square test and Mann-Whitney U tests and receiver operating characteristic (ROC) curve analysis.
RESULTS: A total of 62 patients (31 each with normal findings and testicular tumors) were included. The VI differed statistically significantly (p < 0.001) between normal testis (median 2.5 %) and testicular tumors (median 17.4 %). Like vascular patterns (p < 0.001), the VI (p = 0.030) was shown to distinguish seminomas (median 14.8 %), non-seminomas (median 17.6 %) and lymphomas (median 34.5 %).
CONCLUSIONS: In conclusion, our study has shown the VI to be a quantitative tool that can add information for differentiating testicular tumor entities. While further confirmation in larger study populations is desirable, our results suggest that the VI may be a useful quantitative parameter.
METHODS: This retrospective analysis included patients who underwent testicular US in our department from 2018 to 2022. Inclusion criteria were: i) sufficient image quality of the stored images, ii) US with standardized SMI-default setting (colour gain of 44 ± 5), iii) patient age ≥ 18 years, and iv) normal testicular findings or testicular tumor with histopathological workup. US examinations were performed as part of clinical routine using a high-end ultrasound system (Aplio i800/i900, Canon Medical Systems Corporation, Tochigi, Japan). Statistical analysis included Chi-square test and Mann-Whitney U tests and receiver operating characteristic (ROC) curve analysis.
RESULTS: A total of 62 patients (31 each with normal findings and testicular tumors) were included. The VI differed statistically significantly (p < 0.001) between normal testis (median 2.5 %) and testicular tumors (median 17.4 %). Like vascular patterns (p < 0.001), the VI (p = 0.030) was shown to distinguish seminomas (median 14.8 %), non-seminomas (median 17.6 %) and lymphomas (median 34.5 %).
CONCLUSIONS: In conclusion, our study has shown the VI to be a quantitative tool that can add information for differentiating testicular tumor entities. While further confirmation in larger study populations is desirable, our results suggest that the VI may be a useful quantitative parameter.
摘要：
目的：当怀疑睾丸肿瘤时，超声（US）是主要的成像方式。精湛的微血管成像（SMI）是一种新颖的，高度敏感的多普勒技术，可以通过确定血管指数（VI）来量化血流信号。本研究的目的是探讨SMI衍生的VI在正常睾丸组织和睾丸癌中的诊断意义。
方法：这项回顾性分析包括2018年至2022年在我科接受睾丸US检查的患者。纳入标准是：i)存储图像的足够图像质量，ii)美国标准SMI默认设置(颜色增益为44±5)，iii）患者年龄≥18岁，和iv）正常睾丸发现或睾丸肿瘤与组织病理学检查。作为临床常规的一部分，使用高端超声系统(Aplioi800/i900，佳能医疗系统公司，Tochigi,日本）。统计分析包括卡方检验和Mann-WhitneyU检验以及受试者工作特征(ROC)曲线分析。
结果：共纳入62例患者（31例患者均表现正常，睾丸肿瘤）。正常睾丸（中位数为2.5％）和睾丸肿瘤（中位数为17.4％）之间的VI统计学差异显着（p<0.001）。像血管模式（p<0.001），VI（p=0.030）显示可区分精原细胞瘤（中位数14.8％），非精原细胞瘤（中位数17.6%）和淋巴瘤（中位数34.5%）。
结论：结论：我们的研究表明，VI是一种定量工具，可以增加区分睾丸肿瘤实体的信息。虽然需要在更大的研究人群中进一步确认，我们的结果表明，VI可能是一个有用的定量参数。
方法：这项回顾性分析包括2018年至2022年在我科接受睾丸US检查的患者。纳入标准是：i)存储图像的足够图像质量，ii)美国标准SMI默认设置(颜色增益为44±5)，iii）患者年龄≥18岁，和iv）正常睾丸发现或睾丸肿瘤与组织病理学检查。作为临床常规的一部分，使用高端超声系统(Aplioi800/i900，佳能医疗系统公司，Tochigi,日本）。统计分析包括卡方检验和Mann-WhitneyU检验以及受试者工作特征(ROC)曲线分析。
结果：共纳入62例患者（31例患者均表现正常，睾丸肿瘤）。正常睾丸（中位数为2.5％）和睾丸肿瘤（中位数为17.4％）之间的VI统计学差异显着（p<0.001）。像血管模式（p<0.001），VI（p=0.030）显示可区分精原细胞瘤（中位数14.8％），非精原细胞瘤（中位数17.6%）和淋巴瘤（中位数34.5%）。
结论：结论：我们的研究表明，VI是一种定量工具，可以增加区分睾丸肿瘤实体的信息。虽然需要在更大的研究人群中进一步确认，我们的结果表明，VI可能是一个有用的定量参数。
