The aim of study is to differentiate between testicular tumors by their elastographic criteria (Stiffness [hard to soft] , Shape under compression , etc.) using ultrasound elastography techniques (shear wave/strain elastography) on suspected testicle that showed specific lesion on normal ultrasound examination.

Technique:

Using a linear ultrasound probe supporting elastography techniques, either :

Strain Elastography (SE) SE measures tissue stiffness by applying external tissue pressure [3]. Tissue dimensions change due to the applied pressure; this deformation is termed strain. Stiffer lesions deform less, and have correspondingly lower strain and higher Young's modulus.

In strain imaging, tissue displacement is calculated by processing radiofrequency (RF) datasets obtained before and after compression [4]. Translucent colored elastograms (strain images) can be superimposed on B-mode images to provide complementary anatomic information. It is common to display the strain map as colored pixels on a red/blue scale or gray scale [5].

Or Shear wave elastography (SWE) Shear wave elastography differs from strain elastography, as it is a quantitative method of assessing tissue elasticity by measuring the speed of acoustic radiation force impulse-induced shear waves traveling in the tissue of interest.

The compressive acoustic waves used for conventional B-mode image generation travel at high speeds through soft tissue (1450-1550 m/s). By contrast, mechanical shear waves used for shear wave elastography travel relatively slowly (1-10 m/s). Shear wave propagation velocity depends on tissue stiffness [2, 4].

Data collection:

Data will be recorded as excel spreadsheet and statistical analysis using SPSS software version 22

Computer software: SPSS version 22 statistical software.

Statistical tests: T-test.

Inclusion Criteria:

• i. Age : (15-65 years).
• ii. Patient with history of testicular pain or discomfort or even without clinical symptoms.
• iii. Patient with any predisposing factors as mentioned before in the background.
• iv. Patient with history of cancer of other organs (not testicular tumors).

Exclusion Criteria:

• i. patient refused to be included in the study. ii. infarct correlation with patient history and symptoms is important. iii. Infections as focal orchitis. iv. History of trauma (hematoma exclusion).

male patients with testicular mass lesion