睾丸精原与非精原细胞瘤CT与MRI影像学诊断研究  

The Diagnostic Value of CT and MR Imaging of Testicular Seminomas and Nonseminomas

作　　者：王培旭 陈洁婷 涂蓉[1] WANG Peixu;CHEN Jieting;TU Rong(Department of Radiology,The First Affiliated Hospital of Hainan Medical College,Haikou,Hainan Province 570100,P.R.China)

机构地区：[1]海南医学院第一附属医院放射科,海口570100 [2]中山大学附属肿瘤医院放射科,广州510000

出　　处：《临床放射学杂志》2021年第5期965-969,共5页Journal of Clinical Radiology

摘　　要：目的探讨睾丸精原细胞瘤(SGCT)与非精原细胞瘤(NSGCT)的CT与MRI影像学征象与鉴别诊断价值。方法回顾性分析经病理证实的67例睾丸肿瘤(SGCT 44例,NSGCT 23例)的CT与MR影像学征象,其中39例行肿瘤标志物检查,比较SGCT与NSGCT两组之间各影像学征象的发生率的差异,及肿瘤标志物升高的发生率差异。结果 CT影像中SGCT与NSGCT两组在肿物肿块形态、内部分隔、钙化、延迟强化、间隔强化及不均匀片状强化征象的发生率差异有统计学意义(P<0.05);MR影像中,肿块内部间隔、间隔强化等特征的发生率差异有统计学意义(P<0.05)。甲胎蛋白(AFP)升高的发生率分别为4.5%、82.4%(P<0.001)。结论睾丸SGCT多表现为多结节融合的实性肿块,形态不规则多见浅分叶,少见钙化,早期的纤维间隔强化是其特征性表现;NSGCT则多形态规则,内部可见点片样钙化,部分出现延迟强化,不均匀片状强化为其典型特征;AFP升高主要见于NSGCT。Objective To investigate the CT and MR imaging signs and differential diagnosis value of testicular seminoma and nonseminomatous germ cell tumor(NSGCT). Methods A retrospective analysis of the CT and MR imaging signs of 67 testicular tumors confirmed by pathology(44 cases of seminoma and 23 cases of NSGCT),39 cases of which underwent tumor marker examinations, and compared seminoma and NSGCT.The difference in the incidence of imaging signs and the incidence of elevated tumor markers between the two groups. Results There were statistically significant differences in the incidence of tumor mass morphology, internalseparation, calcification, delayedenhancement, intervalenhancement, and uneven sheet enhancement between the seminoma and NSGCT groups in CT images(P<0.05).In the MR images, there was a statistically significant difference in the incidence of features such as internal septations and septal enhancement in the mass(P<0.05).The incidence of elevated AFP was 4.5% and 82.4%(P<0.001). Conclusion Testicular seminoma are mostly solid masses with multiple nodules and fusion. Irregular morphology is more common with superficial lobes, and calcification is rare.Early fibrous septal enhancement is its characteristic manifestation. NSGCT is more morphological and regular. Spot-like calcification can be seen inside, some delayed enhancement, uneven flaky enhancement is its typical feature.elevation of alpha-fetoprotein(AFP) is mainly seen in NSGCT.

关 键 词：睾丸精原细胞瘤 睾丸非精原细胞瘤 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]