睾丸原发性混合性生殖细胞瘤MRI诊断及临床病理对照分析  

Diagnosis of testicular primary mixed germ cell tumor with MRI and clinical pathological analysis

作　　者：陈倩倩 张焱[1] 程敬亮[1] 白洁[1] 高安康 CHEN Qianqian;ZHANG Yan;CHENG Jingliang;BAI Jie;GAO Ankang(Department of MRI,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院磁共振科,河南郑州450052

出　　处：《实用放射学杂志》2019年第12期1966-1969,共4页Journal of Practical Radiology

摘　　要：目的探讨睾丸原发性混合性生殖细胞瘤(MGCT)的MRI表现、临床病理特点。方法回顾性分析8例经手术证实的睾丸原发性MGCT患者的临床病理及MRI资料;MRI平扫8例,增强扫描7例;对睾丸原发性MGCT的MRI特征进行评估,并与临床病理对照。结果所有病例均发生于单侧睾丸,左侧4例、右侧4例,左右比1:1。8例患者均可见睾丸肿大。大多数肿瘤轮廓不光整,实性7例,囊实性1例。大多数肿瘤在T1WI、T2WI表现为混杂信号,且多以T2稍高信号为主。伴有液化、坏死成分表现为低信号。增强后肿瘤多呈不均匀强化,1例呈渐进性不均匀边缘状强化。8例病变中,同侧的精索静脉曲张3例,伴有睾丸鞘膜积液4例,1例有腹膜后淋巴结转移合并下腔静脉受侵犯。结论睾丸原发性MGCT在MRI多表现为混杂信号,当病变合并有脂肪、钙化、出血、液化等成分时有一定的特征,结合病理的多点取材及免疫组化有助于确诊。Objective To evaluate the MRI features and clinical pathological characteristics of testicular primary mixed germ cell tumor(MGCT).Methods The clinical pathological and MRI data of 8 patients with testicular primary MGCT confirmed by surgery were analyzed retrospectively.Plain MRI were performed in all patients;dynamic contrast-enhanced MRI performed in 7 patients.The MRI features of testicular primary MGCT were evaluated and compared with clinicopathology.Results All cases located in the unilateral testis(4 cases in the left side,4 cases in the right side,ratio of 1:1).Testis enlargement was seen in all patients.7 cases were solid masses,1 case was cystic component-based solid,and incomplete capsule was mainly showed.Most cases were mixed signal intensity on T1WI and T2WI,and slightly longer T2 signal mainly.The cystic components or liquefied necrotic components were low signal.On dynamic contrast-enhanced scan,unevenly enhanced were showed in most cases,progressive uneven edge-like enhancement in 1 case.Of all cases,varicocele were seen in 3 cases,testicular hydrocele in 4 cases,retroperitoneal lymph node metastasis and inferior vena cava invasion in 1 case.Conclusion Most of the testicular primary MGCT show mixed signals in MRI,which have certain characteristics when the lesions are combined with fat,calcification,hemorrhage,liquefaction and other components.Combining pathological multi-point sampling and immunohistochemistry are helpful for diagnosis.

关 键 词：睾丸 混合性生殖细胞瘤 磁共振成像 病理学 

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