儿童睾丸肿瘤的CT诊断  

CT Diagnosis of the Testicular Tumors in Children

作　　者：沈全力[1] 黎元[1] 帕米尔[2] 

机构地区：[1]复旦大学附属华山医院放射科,200040 [2]复旦大学附属儿科医院放射科

出　　处：《中国医学计算机成像杂志》2006年第4期270-274,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨CT在儿童睾丸肿瘤诊断中的应用价值。材料和方法:回顾性分析经手术和病理证实的28例儿童睾丸肿瘤的组织病理、临床特点和CT表现。结果:良性畸胎瘤16例,内胚窦瘤7例,胚胎细胞癌5例。总体发病年龄平均14个月;良性畸胎瘤和内胚窦瘤分别为12个月和14个月,差异无显著性意义(P>0.05);胚胎细胞癌49个月,和前两者差异有显著性意义(P<0.05)。内胚窦瘤和胚胎细胞癌患者的血清甲胎蛋白值明显升高,和良性畸胎瘤患者的差异有显著性意义(P<0.05)。CT平扫5例良性畸胎瘤含钙化、脂肪成分,具有特征性,其余平扫CT征象在3种肿瘤中的差异无显著性意义(P>0.05)。增强后内胚窦瘤和胚胎细胞癌均显著不均匀强化,而良性畸胎瘤多轻度均匀强化或无强化,差异有显著性意义(P<0.05)。7例内胚窦瘤中肺部转移1例。5例胚胎细胞癌中同侧精索增粗伴明显强化2例,其中1例伴后腹膜淋巴结肿大。1例内胚窦瘤和3例胚胎细胞癌患者术后进行了为期1年的随访,血清甲胎蛋白、盆腹腔CT和胸部X线平片均正常。结论:CT扫描并与临床资料相结合,在鉴别儿童睾丸肿瘤良恶性、肿瘤术前分期和术后随访方面具有重要价值。Purpose： To evaluate the role of CT in the diagnosis of testicular tumors in children.Materials and Methods： 28 cases of testicular tumor proved surgically and pathologically were collected for this study. Their clinical features, pathological classification and CT appearances were retrospectively analyzed. Results ：Of the 28 cases, 16 were benign teratomas, 7 were endodermal sinus tumors, 5 were embryonal cell carcinomas. The total average age was 14 months. The average age of cases with benign teratoma and endodermal sinus tumor was 12 months and 14 months respectively （P 〉 0.05） . The average age of cases with embryonal cell carcinoma was 49 months, older than that of the other two tumors （P 〈 0.05）. Serum α - fetoprotein value markedly elevated in all cases with endodermal sinus tumor and embryonal cell carcinoma and normal in all cases with benign teratoma（P 〈 0.05） . On plain CT scan, calcification and fat could be seen in 5 benign teratomas, other CT findings had no statistic significance among three kinds of the testicular tumor （P 〉 0.05）. On contrast CT scan, endodermal sinus tumors and embryonal cell carcinomas showed marked nonhomogeneous enhancement, benign teratomas showed slight enhancement or no enhancement （P 〈 0.05）. 1 case with endodermal sinus tumor occurred lung metastasis. The ipsilateral spermatic cord thickened and markedly enhanced in 2 cases with embryonal cell carcinoma, and there was retroperitoneal lymphadenopathy in 1 case. 1 case with endodermal sinus tumor and 3 cases with embryonal cell carcinoma followed up for 1 year after surgery and no evidence of metastases was found. Conclusion ： Combined with clinical reference, CT plays an important roll in the differentiation between benign and malignant testicular tumors in children, tumor staging before therapy and surveillance after therapy.

关 键 词：儿童 睾丸肿瘤 CT 

分 类 号：R737.21[医药卫生—肿瘤] R737.31[医药卫生—临床医学]