Application value of strain elastography in testicular injury assessment after torsion

Aim: To evaluate the capability of strain elastography (SE) in assessing the degree of testicular injury after torsion.

Material and methods: In total, 50 rabbits were divided into four groups according to different degrees of testicular torsion (TT) at 0°, 180°, 360°, and 720°. For each animal, according to the tissue stiffness distribution, an SE score and strain ratio (SR) were obtained. With the histopathological results as the reference, the correlation coefficients of the apoptotic index and SE score or SR were calculated, and the receiver operating characteristic (ROC) curves were created to assess the capability of SE in assessing the degree of testicular injury.

Results: A significant positive correlation was found between the apoptotic index and SE score, as well as the SR, with corresponding correlation coefficients of 0.70 (<0.001) and 0.68 (P = 0.001), respectively. The areas under the ROC curves (AUCs) of the SE score and SR for identifying ischemia/hypoxia injury were found to be 0.81 (95% CI, 0.71-0.93) and 0.73 (95% CI, 0.60-0.86), respectively. For identifying irreversible damage, the AUCs were 0.69 (95% CI, 0.56-0.83) and 0.71 (95% CI, 0.59-0.84) for the SE score and SR, respectively.

Conclusions: SE scores exhibited good diagnostic capability for detecting ischemia/hypoxia injury after TT. In early identification of severe injury/necrosis following TT, SE demonstrated some value but was not ideal.