血精性精囊腺炎的磁共振成像表现分析  

The diagnostic analysis of MRI in hematospermia seminal vesiculitis

作　　者：夏标 张天富 吴海璐 苏伟[2] 何茜[2] Xia Biao;Zhang Tianfu;Wu Hailu;Su Wei;He Qian(Department of Medical Imaging,Chenggong Hospital of Yan'an Hospital Affiliated to Kunming Medical University(1 Medical Imaging Department of Chenggong District People's Hospital),Kunming 650500,China;Department of Radiology of Fourth Affiliated Hospital of Kunming Medical University.Kunming 650021,China)

机构地区：[1]昆明医科大学附属延安医院呈贡医院(呈贡区人民医院)医学影像科,650500 [2]昆明医科大学第四附属医院放射科,650021

出　　处：《中国临床实用医学》2019年第6期37-41,共5页China Clinical Practical Medicine

摘　　要：目的分析血精性精囊腺炎的磁共振成像影像特征,探讨磁共振成像在血精性精囊腺炎中的诊断价值.方法选取2015年4月至2018年4月昆明医科大学附属延安医院呈贡医院(呈贡区人民医院)泌尿外科收治的13例男性血精性精囊腺炎患者,年龄(28.4±6.7)岁,年龄范围为20~82岁.扫描序列分为快速自旋回波(TSE)T2WI序列横断面扫描、TSE T2WI序列加脂肪抑制技术扫描(矢状面、冠状面及横断面)、TSE T1WI序列横断面扫描及容积内插体部扫描(VIBE)序列(矢状面、冠状面及横断面),观察分析患者精囊腺大小及信号变化.结果13例患者中,7例病变累及双侧精囊腺,6例发生于单侧精囊腺;20个精囊腺增大,6个精囊腺未增大.13例患者均有T2WI像上显示滤泡状结构不同程度减少,T1WI像上精囊腺表现为信号不同程度增高.2例无并发症、4例合并前列腺增生、1例合并前列腺苗勒管囊肿、2例增强后轻度强化(其中1例腹腔镜下前列腺癌根治术后病理显示前列腺癌合并右侧外周带、左侧精囊出血,双侧精囊腺对称性增大;另1例膀胱镜术后病理显示合并膀胱炎性息肉伴灶性区域尿路上皮轻度非典型增生,双侧精囊不大)、4例治疗后随访复查(其中1例1周后复查变化不明显;2例治疗后3月复查及1例治疗后6月复查,均显示精囊腺于T1WI像上信号下降,接近正常).结论磁共振成像是诊断血精性精囊腺炎的重要影像手段,精囊腺于T1WI像上信号增高比较有特征性,如合并T2WI加脂肪抑制序列上显示滤泡状结构减少,囊壁模糊,则诊断更准确.Objective To analyze the magnetic resonance imaging(MRI)characteristics of hema-tospermia seminal vesiculitis(HSV)and investigate the diagnostic value of MRI in HSV.Methods From April 2015 to April 2018,13 cases of male patients with hematospermia who were admitted were selected.They were aged(28.4±6.7)years old,ranging from 20 to 82 years old.Scan sequences were divided into turbo spin echo(TSE)T2WI cross-sectional scanning,TSE T2WI sequence with fat suppression technique scanning(sagittal and coronal and transverse section),TSE T1WI sequence cross-sectional scanning,and volume interpolated body examination(VIBE)sequence(sagittal and coronal and transverse section),the seminal vesicle gland size and signal changes of the patients were observed and analyzed.Results Of the 13 cases,7 cases involved bilateral seminal vesicles,and 6 cases involved unilateral seminal vesicles.Twen-ty seminal vesicles were enlarged,and six were not.All the 13 patients had decreased follicular structure in T2WI image,and increased signal in T1WI image.There were no complications in 2 cases.Four cases were complicated with prostatic hyperplasia.One case was complicated with prostate Mullerian duct cyst.Two ca-ses of mild enhancement after enhancement(one of them showed prostate cancer combined with right pe-ripheral zone and left seminal vesicle hemorrhage after radical resection of prostate cancer under laparo-scope,bilateral seminal vesicle gland symmetry increased.The pathology of the other case after cystoscope showed mild atypical hyperplasia of urinary tract epithelium with bladder inflammatory polyps and focal re-gion,and small seminal vesicles on both sides).Four cases were followed up for reexamination after treatment(1 case had no obvious change after 1 week.Reexamination at 3 months after treatment in 2 cases and 6 months after treatment in 1 case showed that the seminal vesicle signal decreased on T1WI and was close to normal).Conclusion MRI is an important method for diagnostic analysis in the hematospermia seminal ve-sicu

关 键 词：精囊腺炎 血精 磁共振成像 盆腔 容积内插体部扫描 

分 类 号：R73[医药卫生—肿瘤]