睾丸肿瘤与结核的CT表现分析  

CT manifestations of testicular tumors and tuberculosis

作　　者：边巴次仁 次旦旺久[1] 任翠 雷彦明[1] Bianba Ciren;Cidan Wangjiu;Ren Cui;Lei Yanming(Department of Radiology,the People's Hospital of Tibet Autonomous Region,Lhasa 850000,China;Department of Radiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]西藏自治区人民医院放射科,拉萨850000 [2]北京大学第三医院放射科,北京100191

出　　处：《国际泌尿系统杂志》2025年第1期77-80,共4页International Journal of Urology and Nephrology

摘　　要：目的分析睾丸肿瘤与睾丸结核的CT影像表现,提高两种疾病的鉴别诊断能力。方法回顾性分析2018年1月至2023年6月在西藏自治区人民医院收治的49例睾丸病变患者的临床资料,其中睾丸结核24例,睾丸肿瘤25例。所有患者均接受全腹部增强CT检查,分析比较两种疾病的CT增强扫描病灶范围、成分、密度、强化方式及是否伴有淋巴结增大等影像学表现。结果睾丸结核患者病变的最大截面积为(10.37±7.69)cm^(2),睾丸肿瘤性患者病变的最大截面积为(55.56±41.36)cm^(2),差异有统计学意义(t=4.917,P<0.001)。睾丸结核与睾丸肿瘤患者的平扫CT值比较,差异无统计学意义(t=1.442,P=0.158)。睾丸结核患者中有5例(20.8%)有钙化,表现为实性肿块中央或囊变区的囊壁多发斑点状钙化,1例(4.2%)钙化形态为蛋壳样,钙化大小差异较大;5例(20.8%)表现为淋巴结阳性,多为孤立、圆形或卵圆形的淋巴结,淋巴结短径为1.0~1.5 cm,肿大淋巴结均无液化坏死,多分布于腹股沟及腹膜后,16例(66.7%)伴有睾丸鞘膜积液,未见隐睾和腹股沟管增宽;10例(41.7%)合并肾脏结核。睾丸肿瘤患者中有6例(24.0%)有钙化,多表现为边缘点状、条状钙化,大小相仿,长径约为0.6 cm;20例(80.0%)表现为淋巴结增大,为多发肿大淋巴结相互融合,中央可见液化坏死;3例(12.0%)伴有睾丸鞘膜积液,4例(16.0%)合并隐睾,15例(60.0%)伴有同侧腹股沟管增宽。结论睾丸结核和睾丸肿瘤性病变的CT影像表现各具有一定特点,CT增强扫描有助于二者的鉴别诊断。Objective To analyze the CT findings of testicular tumor and testicular tuberculosis,and to improve the differential diagnosis of the two diseases.Methods The clinical data of 49 patients with testicular lesions admitted to the People's Hospital of Tibet Autonomous Region from January 2018 to June 2023 were retrospectively analyzed.All patients underwent whole abdominal enhanced CT examination with complete data.The imaging manifestations such as lesion range,composition,density,enhancement mode,and presence of lymph node enlargement of the two diseases were analyzed and compared.Results The maximum cross section of testicular tuberculosis was about(10.37±7.69)cm^(2),and that of testicular tumor was about(55.56±41.36)cm^(2),the difference between the two was statistically significant(t=4.917,P<0.001).There was no significant difference in plain CT values between testicular tuberculosis and testicular tumor lesions(t=1.442,P=0.158).Among the patients with testicular tuberculosis,5 cases(20.8%)had calcification,manifested as multiple spot-like calcification in the cyst wall of the central or cystic area of the solid mass.One case(4.2%)had eggshell-like calcification with great difference in size of calcification.Five cases(20.8%)showed positive lymph nodes,mostly solitary,round or oval lymph nodes.Lymph nodes with a short diameter of 1.0-1.5 cm were not necrotic,and the enlarged lymph nodes were mostly distributed in the groin and retroperitoneum.Sixteen cases(66.7%)were accompanied by hydrocele of testis,no cryptorchidism or widening of the inguinal canal were observed,and 10 cases(41.7%)were accompanied by renal tuberculosis.Among the patients with testicular tumor,6 cases(24.0%)had calcification,mostly manifested as marginal dot and strip calcification,with a similar size and a long diameter of about 0.6 cm.Twenty cases(80.0%)showed enlargement of lymph nodes,multiple enlarged lymph nodes fused with each other,and central necrosis.Three cases(12.0%)were accompanied by testicular hydrocele.There were 4 cases(16

关 键 词：睾丸肿瘤 结核 体层摄影术 螺旋计算机 

分 类 号：R73[医药卫生—肿瘤]