成人睾丸良性肿瘤的影像学特点

Imaging Features of Adult Benign Testis Tumors

目的分析不同类型成人睾丸良性肿瘤的影像学特点及临床表现,提高对睾丸良性肿瘤的认识。方法回顾性分析我院经手术病理证实的10例睾丸良性肿瘤患者的临床资料,包括病史、肿瘤标记物、影像学资料等。结果10例患者的肿瘤指标均在正常范围。病理证实支持细胞瘤3例,影像表现为类圆形肿块,内部为低回声或软组织肿块,边界清晰,包膜完整,内部回声或密度欠均匀,增强扫描示病灶呈轻度不均匀强化;腺瘤样瘤2例,超声表现为患侧睾丸内类圆形低回声区,内有形态不规则强回声光条,后方有声影,CDFI见其内血流增多。表皮样囊肿2例,超声表现为类圆形肿块,边界清楚,内部回声高低不等;CT扫描密度均匀,增强后无强化。MRI表现为T1W呈高低混杂信号,T2W以高信号为主,中心见条片状低信号,边缘见线样低信号环,增强扫描无明显强化。卵泡膜瘤/纤维瘤1例,超声表现为患侧睾丸内圆形低回声肿块,分布不均匀,CDFI示睾丸内肿物可见丰富条状血流。间皮瘤1例,CT表现为类圆形低密度肿块,边界清楚,密度均匀,增强扫描轻度强化。成熟型畸胎瘤1例,超声表现为阴囊内强回声团,后方伴声影,边界清,CDFI未见异常彩色血流显示;CT图像可见蛋壳样钙化及脂肪密度,增强后未见明显强化。结论睾丸良性肿瘤少见,影像表现具有一定特征性,多种影像学方法联合应用能有效提高睾丸良性肿瘤的诊断率,从而减少不必要的睾丸切除。

Objective To study the clinical manifestations and imaging features of adult benign testicular tumors by analysis of clinical and imaging data to raise awareness of benign tumors.Methods To retrospectively analyze the clinical data(including the medical history,tumor markers,imaging information and etc)of 10 cases of benign testicular tumors which were confirmed by pathology and treated in our hospital.Results The tumor markers were within a normal range in all patients.Postoperative pathology examination showed that there were 3 cases of Sertoli cell tumor.Imaging showed round mass,internal hypoechoic or soft tissue mass,clear boundaries,encapsulated,internal echoes or less homogeneous density.Enhanced scan showed mild heterogeneous enhancement.Two cases of adenomatoid tumor,ultrasound showed a circular hypoechoic area in the testis on the affected side,with irregular and strong echolucent strips,and posterior acoustic shadowing and increased blood flow signal on CDFI.In 2 cases of epidermoid cysts,ultrasound showed round masses with clear boundaries and varying internal echoes.CT scanning showed uniform density,without enhancement.MRI showed that T1W showed mixed signals of high and low signals,and T2W was mainly high-intensity,with strips of low-intensity in the center and linear low-intensity loops at the edges.In one case of thecoma/fibroma,Ultrasound showed ipsilateral testis round hypoechoic mass with non-uniform distribution and CDFI showed visible strip rich vascularity.In one case of mesothelioma,CT scanning showed round mass density with clear boundary and uniform density and enhanced scan showed mild enhancement.In one case of mature teratoma,Ultrasound showed hyperechoic mass with rear acoustic shadowing and clear boundary,no abnormal blood flow signal.CT image showed eggshell calcification and fat density,without significant enhancement.Conclusion Testicular benign tumors are rare,imaging examination has certain characteristics,which can effectively improve the diagnosis rate of testicular benign tumors,thereby reducing the performance of unnecessary orchiectomy.