苗勒氏管囊肿与射精管囊肿经直肠超声检查的表现及鉴别诊断  

Differentiation Between Müllerian Duct Cyst and Ejaculatory Duct Cyst with Transrectal Ultrasonography

作　　者：贾文秀[1] 朱强[1] 冀鸿涛[1] 肖萍[1] 张歧山[1] 

机构地区：[1]首都医科大学附属北京同仁医院超声诊断科,北京市100730

出　　处：《中国超声医学杂志》2008年第4期346-349,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨苗勒氏管囊肿(Müllerian ductcyst,MDC)及射精管囊肿(ejaculatory ductcyst,EDC)经直肠超声的声像图表现及鉴别诊断。方法收集经直肠内超声检查所发现的前列腺囊肿患者80例。年龄25～83岁,平均59.3岁。观察囊肿形态、位置、与精阜的关系、是否与精囊相通,如果不典型则行排精试验,观察射精管排泄物与囊肿的关系,以区别MDC和EDC。结果80例患者中,典型MDC有13例,呈纯囊性病灶,位于前列腺基底部、尿道后上方中线处,与精囊和输精管无相连;典型EDC有39例,表现与MDC相同,然而纵切面位于前列腺前下方中央区、尿道后侧,横切面位于前列腺中央区、偏一侧之射精管行程上;囊肿可指向精阜(36例),可伴同侧精囊扩张(23例)及同侧输精管扩张(2例)。排精试验(28例)中,因排泄物通过囊肿后再进入后尿道(8例)、进入并滞留于囊肿内(10例)及未发生排泄(8例)而诊断为EDC,因排泄物从囊肿外周绕行而诊断为MDC(2例)。结论MDC和EDC在声像图上所在方位、与精阜及精囊的关系、排精时排泄物与囊肿的关系有所不同,以此鉴别可为临床制定治疗方案提供依据。Abstract： Objective To assess the differentiation of Miǖllerian duct cyst （MDC） from ejaculatory duct cyst （EDC） using transrectal ultrasonography （TRUS） . Methods From November 1992 to June 2006, 80 patients with prostate cystic lesion were detected on TRUS. The position, relationship to verumontanum seminal vesicles or ejaculatory ducts were observed and the spermiation test was done. Results Of the 80 patients （80 cysts）, 13 having typical MDC showed as pure cystic lesions, located in the midline region from the prostatic base behind the urethra, and did not link to the seminal vesicles and/or ejaculatory ducts; 39 with typical EDC presented with sonographic appearances similar to MDC on TRUS, however, they arose differently from the infra-anterior position of the prostate central zone behind the urethra in sagittal images and the central zone paramedially on the course of ejaculatory ducts in transverse images and usually pointed to the verumontanum （n = 36）, and possibly connected with ipsilateral dilated seminal vesicles （n = 23） and/or ejaculatory ducts （n = 2） . In spermiation （n = 28）, EDC was confirmed because the semen was excreted to the urethra through the cyst （n=8） or it stayed inside the cyst （n=10） or the ipsilateral spermiation did not occur （n= 8）; MDC was proven at the semen excretion by passing the cyst into the urethra （n= 2）. Conclusions TRUS may be the useful method for distinguishing between MDC and EDC via the cyst location, the association of lesions with verumontanum and seminal vesicles or ejaculatory ducts, and the spermiation test.

关 键 词：前列腺 苗勒氏管囊肿 射精管囊肿 经直肠超声诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]