Real-time sonoelastography' in anterior urethral strictures: A novel technique for assessment of spongiofibrosis

摘要

Introduction Spongiofibrosis assessment is critically important in the evaluation of anterior urethral stricturesas its severity is directly proportional to stricture recurrence and thus affects management. Retrogradeurethrography (RGU) is ineffective in the evaluation of spongiofibrosis. Sonourethrography (SUG)delineates it but does not accurately estimate its depth. Real-time elastography (RTE), a newer techniquethat not only attempts a qualitative but also quantitative estimation of spongiofibrosis (tissue stiffness)which results due to underlying pathological processes.Material and methods In the present study, various elastographic patterns and strain ratios in anteriorurethral stricture patients were studied and compared to operative and histopathological findings. SixtythreeRGU diagnosed anterior urethral stricture cases were taken and re-evaluated by SUG and SE by anotherradiologist who was blinded to the findings of the RGU. Strain patterns and ratios of spongiofibroticsegments were documented and compared with operative findings as gold standard.Results Blue pattern on RTE showed 100% concordance with severe fibrosis as evaluated againsthistopathological findings whereas green pattern showed 87.5% concordance with moderate degreeof fibrosis. Severe degree of fibrosis cases, confirmed on histopathology had a significantly higher meanstrain ratio (10.51 ±2.297) as compared to moderate degree (6.33 ±2.353) (p <0.001 S).Conclusions Real time sonoelastography in the evaluation of spongiofibrosis not only assesses it qualitativelybut also quantifies it. Strain ratios are statistically better indicators for estimating spongiofibrosis