睾丸肿瘤的临床特点和MRI表现  

MRI and clinic features of testicular tumor

作　　者：龙德云[1] 陈和平[1] 张联合[2] 柳杰 叶孝权 周涛[1] 陈明安[1] 

机构地区：[1]武警浙江省总队医院放射科,浙江嘉兴314000 [2]武警浙江总队杭州医院放射科 [3]武警浙江总队卫生处 [4]武警浙江省总队医院病理科

出　　处：《实用放射学杂志》2013年第11期1807-1810,1822,共5页Journal of Practical Radiology

摘　　要：目的 探讨睾丸肿瘤的MRI表现及临床特点,旨在提高对该病的诊断水平.方法 回顾性分析36例经手术和病理证实的睾丸肿瘤的临床资料和MRI表现.所有病例均行MRI平扫,其中6例行MRI增强扫描,主要观察肿块的大小、形态、信号及其与周围组织结构的关系,并与病理结果对照.结果 36例睾丸肿瘤中,无意中发现睾丸肿块12例,伴有酸胀沉重或下坠感24例;隐睾病史4例,斜疝3例.36例睾丸肿瘤中,精原细胞瘤13例,T2WI呈均匀低信号6例,结节状低信号1例,以低信号为主的混杂信号6例,其中含有低信号纤维间隔8例;浆细胞肿瘤2例（3个病变睾丸）,肿块信号均匀,强化显著;胚胎癌7例,均呈混杂不均匀信号,肿块均较大,6例有远处转移,1例合并恶性畸胎瘤,患者发病年龄均＜32岁;恶性淋巴瘤8例,T2WI呈均匀低信号3例,呈混杂信号5例,附睾精索侵犯5例,其中6例患者发病年龄＞62岁;Leydig细胞瘤6例,T2WI呈均匀低信号3例,呈混杂信号3例,鞘膜积液4例.结论 MRI的多方位、多序列扫描技术有助于睾丸肿瘤及其周围组织结构的清晰显示,结合患者发病年龄及临床资料,MRI可对大多数不同病理类型的睾丸肿瘤作出鉴别诊断.Objective To evaluate the MRI and clinic features of testicular tumor and to improve the diagnosis potency of the disease. Methods MRI and clinic features of 36 patients with surgically and pathologically confirmed testicular tumor were reviewed retrospectively. All the 36 cases were performed plain MRI scanning and 6 cases were performed enhanced MRI scanning. The size, morphological characteristics, signals and surrounding conditions of the tumors were observed and the correlation with clinical and pathological data were analysed. Results Among 36 cases, twelve cases of testicular tumor were found accidentally,24 cases complained a sense of heavy and dropping, d patients had a history of cryptorchidism and 3 had hernia. Among the 13 cases of seminoma, six showed homogeneous low signal intensity on T2-weighted images and one case showed nodular low signal, while the other six cases had predominantly low intensity on T2-weighted images with small areas of hemorrhage or necrosis. Fibrous septum of low signal intensity on T2 weighted images were detected in 8 cases. 2 cases of plasma cell tumors revealed homogeneous intensity and markedly enhancement after contrast material administration. All the 7 patients with embryonal carcinoma were younger than 32 years of age. These lesions were usually large and markedly inhomogeneous on T2-weighted images. Six patients had distant metastases and one patient had coexisted malignant teratoma simultaneously. Malignant lymphoma were found in 8 cases, with onset ages were more than 62 years old in 6 cases. 3 cases had homogeneous hypointensity on T2 weighted image and 5 cases showed mixed signals with necrosis or hemorrhage . Invading the epididymis or spermatic cord in found in 5 cases. Among 6 cases of Leydig cell tumor, 3 had homogeneous low signal intensity on T2-weighted images and 3 cases showed mixed signals,4 had hydrocele. Conclusion MRI could clearly display the testicular tumors and their surrounding structures. It will be helpful in differential diagnosis between di

关 键 词：睾丸 肿瘤 磁共振成像 

分 类 号：R737.21[医药卫生—肿瘤] R445.2[医药卫生—临床医学]