title: Colour Doppler and ultrasound characteristics of testicular Leydig cell tumours.
abstract: OBJECTIVE
  To assess the colour Doppler and ultrasound features of testicular Leydig cell tumours (LCTs) in a population of 38 surgically proven lesions.
  
  
  METHODS
  From August 2008 to March 2015, we retrospectively included 38 surgically proven LCTs in 36 patients. Clinical data, scrotal colour Doppler, B-mode ultrasound and videos images were reviewed for each patient. The volume, echotexture of the testis, size, shape, echogenicity and the vascularization pattern of the lesion were evaluated. The tumour margins were categorized as either smooth or lobulated. The vascularization was classified as intense, moderate or without any hypervascularization. We defined the vascularization pattern groups as central, peripheral and mixed (the latter meaning both central and peripheral).
  
  
  RESULTS
  26 patients were referred for infertility [5 patients were subsequently diagnosed with Klinefelter syndrome (KS) and 5 patients with cryptorchidism]. 28 patients underwent testis-sparing surgery, while 8 patients underwent a radical orchiectomy. The LCTs were mostly infracentimetric (68.4%), with a median size of 7.0 mm (ranging from 4.0 to 11 mm). 50% of the lesions had lobulated margins, and these were significantly larger than the smooth lesions (p < 0.05). The content of the lesions was markedly homogeneous and hypoechoic. All lesions had sharp demarcations from the adjacent pulp. 36/38 lesions exhibited moderate-to-intense hypervascularization, with a mixed intrinsic and peripheral rim pattern. Larger lesions were more hypervascularized (p < 0.05). LCTs in patients with KS had atypical features.
  
  
  CONCLUSIONS
  Typical sporadic LCTs appeared as isolated hypoechoic, infracentimetric masses, with a clear demarcation from the adjacent pulp. They presented intrinsic and peripheral rim hypervascularization.
  
  
  CONCLUSIONS
  By undertaking the largest imaging series of LCT to date (to our knowledge), we reassessed the typical sonographical aspects of LCTs, so as to provide guidance in regard to opting for testis-sparing surgery and for follow-up. LCTs present both intrinsic and rim vascularization detectable by colour Doppler ultrasound. Intrinsic vascularization and lobulated margins are common findings in testicular LCTs.
authors.affiliation: 1 Department of Radiology, Bicêtre University Hospital, Paris, France.
authors.forename: Florian
authors.initials: F
authors.lastname: Maxwell
authors.affiliation: 2 Department of Urology, Bicêtre University Hospital, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Izard
authors.affiliation: 3 Department of Pathology, Bicêtre University Hospital, Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Ferlicot
authors.affiliation: 4 Department of Public Health and Epidemiology, Bicêtre University Hospital, Paris, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Rachas
authors.affiliation: 5 Departement of Radiology, Necker Hospital, Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Correas
authors.affiliation: 2 Department of Urology, Bicêtre University Hospital, Paris, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Benoit
authors.affiliation: 1 Department of Radiology, Bicêtre University Hospital, Paris, France.
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Bellin
authors.affiliation: 1 Department of Radiology, Bicêtre University Hospital, Paris, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Rocher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007984:Leydig Cell Tumor / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging*; D013737:Testis / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D055815:Young Adult