睾丸精原细胞瘤与非精原生殖细胞瘤的影像表现  

Imaging features of seminomas and nonseminomatous germ cell tumors

作　　者：李子园[1] 管民[1] 史立刚[2] 朱绍成[1] 史大鹏[1] 

机构地区：[1]河南省人民医院放射科,郑州450003 [2]河南省人民医院病理科,郑州450003

出　　处：《中华放射学杂志》2015年第6期445-448,共4页Chinese Journal of Radiology

基　　金：国家自然科学基金（2012AA011603）;河南省中青年科技创新人才工程专项基金（201052）

摘　　要：目的：探讨睾丸精原细胞瘤和非精原细胞瘤（NSGCT）的影像表现。方法回顾性分析经手术病理证实的25例睾丸生殖细胞瘤患者的25个睾丸肿瘤病灶，其中12例精原细胞瘤，13例NSGCT。12例精原细胞瘤中，5例行CT平扫，其中4例同时行CT增强扫描；7例行MRI平扫，其中4例同时行动态增强扫描。13例NSGCT中，5例行CT平扫，其中2例同时行CT增强扫描；8例行MRI平扫，其中4例同时行动态增强扫描。观察精原细胞瘤和NSGCT病灶的形态、密度信号和强化表现，并采用Fisher检验进行比较。结果12个精原细胞瘤中，10个病灶呈分叶或结节状，5个呈混杂密度或信号；13个NSGCT中，仅有1个（胚胎性癌）呈浅分叶状，11个呈混杂密度或信号。7个行MRI的精原细胞瘤病灶，T2WI均为低信号；8个NSGCT中仅2个T2WI为低信号。4个行MRI动态增强扫描的精原细胞瘤病灶中，3个可见纤维间隔明显强化，6个NSGCT均未见纤维间隔。精原细胞瘤和NSGCT患者以上征象的出现率差异均有统计学意义（P均〈0.05）。结论睾丸精原细胞瘤和非精原细胞瘤的CT和MRI表现具有一定特征性，对于鉴别诊断有一定价值。Objective To explore the imaging characteristics of seminomas and nonseminomatous germ cell tumors （NSGCT） and its pathological foundation. Methods CT and MR imaging manifestations in 25 cases of testicular germ cell tumors proved by pathological examinations were analyzed retrospectively. All tumors were divided into seminomas group （12 cases） and NSGCT group （13 cases）. In the seminomas group, 5 cases were examined by CT and 4 of those also had contrast enhanced CT. Seven cases had MRI and 4 of those had dynamic enhanced MRI. In the NSGCT group, 5 were examined by plain CT in which two were by contrast enhanced CT, eight were by MRI in which 4 were by dynamic enhanced MRI. CT or MRI characteristics （morphology, density or intensity, enhancement） in both groups were analyzed by Fisher test. Results Histological examination revealed 25 intratesticular lesions. In 12 seminomas, 10 showed a nodular/lobulated shape, 5 showed a mixed density or intensity. In 13 NSGCT, only one lesion showed a lobular shape, 11 showed a mixed density or intensity. Seven seminomas showed a low signal on T2WI on MRI while only two NSGCT showed this sign. In four lesions underwent dynamic MRI scanning, 3 showed fibrous septum enhancement while no lesions in NSGCT showed this sign. The occurrence rate of the above imaging characteristics in both group was significantly different （P〈0.05）. Conclusion Seminomas and NSGCT may have their own CT and MRI characteristics, which may be of great value for differential diagnosis .

关 键 词：睾丸肿瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R737.21[医药卫生—肿瘤]