title: Testicular adrenal rest tumors in boys with congenital adrenal hyperplasia: 3D US and elastography--do we get more information for diagnosis and monitoring?
abstract: BACKGROUND
  Testicular adrenal rest tumors (TART) are the nodular testicular lesions deriving from the adrenal remnant tissue reported in boys and men with congenital adrenal hyperplasia. Until now, the diagnostics of TART have been based on a combination of clinical features, imaging methods (primarily two dimensional ultrasound--2D US), response of the foci to glycocorticosteroid (GCS) therapy and exclusion of the neoplastic process. Application of 2D US supplies however a limited range of information about the volume, demarcation, structure and vascularization of the lesions.
  
  
  OBJECTIVE
  To define whether the use of 3D US, power Doppler and elastography changes the algorithm of the diagnostics and monitoring or treatment of TART.
  
  
  METHODS
  In this study, modern ultrasound techniques such as 3D US and elastography were introduced in two boys with TART.
  
  
  RESULTS
  The 3D power Doppler option gives the opportunity for accurate assessment of the volume of testes and adrenal tissue foci and their vascularization. Sonographic elastography allows the assessment of stiffness of adrenal tissue areas compared to normal testis parenchyma.
  
  
  CONCLUSIONS
  The use of these modern techniques enables more adequate and advanced diagnostics, and more precise monitoring of the effects of treatment in patients with TART.
authors.affiliation: Department of Pediatric Radiology, Medical University of Lublin, Chodzki 2, 20-093 Lublin, Poland. Electronic address: gjedrzejewski@wp.pl.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Jedrzejewski
authors.forename: Iwona
authors.initials: I
authors.lastname: Ben-Skowronek
authors.forename: Magdalena Maria
authors.initials: MM
authors.lastname: Wozniak
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Brodzisz
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Budzynska
authors.forename: Andrzej Pawel
authors.initials: AP
authors.lastname: Wieczorek
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000000981:diagnostic imaging*; D000314:Adrenal Rest Tumor / Q000151:congenital / Q000000981:diagnostic imaging*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D016903:Drug Monitoring / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005438:Fludrocortisone / Q000008:administration & dosage; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D008297:Male; D013736:Testicular Neoplasms / Q000151:congenital / Q000000981:diagnostic imaging*; D013737:Testis / Q000098:blood supply / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler / Q000379:methods*
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D005438:Fludrocortisone; D006854:Hydrocortisone
keywords: 3D US; Adrenal rest; Elastography; Vascularization index