The role of ARFI elastography to evaluate microstructrual changes of patients with testicular microlithiasis

Abstract

Background: Testicular microlithiasis (TML) is thought to cause microstructural changes in the parenchyma of the testis, but it is difficult to demonstrate this by ultrasonography. It may be possible to evaluate microstructural changes in the testis by Acoustic Radiation Force Impulse (ARFI) elastography, which measures tissue stiffness. Purpose: To assess the tissue stiffness of testicles of children with TML and to compare them with the healthy control group. Material and Methods: Between November 2015 and May 2016, 25 pediatric patients with TML and 24 healthy children were enrolled in the study (mean age for TML and control group 6.7 +/- 3.17 and 7.9 +/- 4.18 years, respectively). Testicular volumes and mean shear wave velocity (SWV) values were calculated and compared with each other in both groups. Results: There was no significant difference in average testicular volumes between the TML group and the control group (1.14 cm(3), 1.21 cm(3), respectively; P = 0.986). Mean SWV of the testicles with TML and normal testicles with control group was 1.18 +/- 0.22 cm/s and 0.88 +/- 0.11 cm/s, respectively. The SWV of the testicles with TML was higher than the normal testicles and this was statistically significant (P < 0.001). Conclusion: This study has shown that tissue stiffness in patients with TML is increased compared to the normal population. ARFI elastography helps the early detection of microstructural changes in TML and can be used for screening and follow-up.