经皮穿刺输精管精囊造影在CT介入诊断(PVSVG-CT)中的应用研究

A RESEARCH INTO THE APPLICATION OF PVSVG IN CT INTERVENTIONAL DIAGNOSIS

目的：分析经皮穿刺输精管注药精囊显影后的ＣＴ图像资料，探讨ＰＶＳＶＧ－ＣＴ对精囊及周围脏器疾病的诊断及鉴别诊断作用。方法：行ＣＴ扫描和ＰＶＳＶＧ－ＣＴ检查，同时对有相应症状和ＣＴ表现（未作ＰＶＳＶＧ－ＣＴ）的６０例病人的图像及临床资料作为对照组进行回顾性分析。结果：对照组诊断前列腺肿瘤１５例，实验组诊断９例，经统计学处理（Ｐ＞０．０５），无显著性差异。对照组诊断精囊炎１１例，实验组诊断２３例，经统计学处理（Ｐ＜０．０５），有显著性差异。结论：ＣＴ虽然作为膀胱、前列腺和精囊等疾病诊断的重要手段，但是对前列腺肥大或肿瘤早期诊断有一定限制，特别是当前列腺与精囊及膀胱底融合为软组织块状影，界线不清时，与肿瘤外侵不易鉴别。用ＰＶＳＶＧ－ＣＴ法后，可使精囊显影，从不同的断面上区别精囊与周围器官的关系，对前列腺增生、前列腺癌、膀胱后壁肿瘤、直肠前壁的肿瘤侵犯精囊、精囊肿瘤、精囊的炎性病变，具有重要的诊断价值。

Objective:To analyze CT imaging data following percutaneous vasoseminal vesiculography(PVSVG) and explore the role of PVSVG CT in the diagnosis and differential diagnosis of the diseases originated from seminal vesicle and its peripheral organs.Methods: A hundred twenty patients were divided into following two groups:①Sixty patients which were clinically diagnosed to have the tumors of seminal vesicle and prostate because of dysuria,hematuria,and hematospermia were taken as experimental group to undergo CT scans and PVSVG CT examinations;②Other sixty patients which had the clinic signs and CT findings corresponding to the patients in experimental group but did not undergo PVSVG CT examination,were taken as control group and their imaging and clinic data were analyzed retrospectively.Of the total cases 29 were proved by postoperative pathology,including 17 cases (28.33% of 60) in control group,and 12 cases (20% of 60) in experimental group.Besides,others were proved by B model ultrasound and clincal signs.Results:Prostatic tumor diagnosed in control group and experimental group were 15 cases and 9 cases respectively,P>0.05 (non significant difference),while seminal vesiculitis diagnosed in control group and experimental group was 11 cases and 23 cases,respectively,P<0.05(significant difference).Conclusion:CT is important means for diagnosing the diseases originated from bladder,prostate and seminal vesicle but it does not entirely satisfy early diagnosing prostatomegaly or tumor.Especially,when their border was unclear because of prostate,seminal vesicle and bladder basis conjugating each other into the shadow like a soft tissue mass,it is difficult for CT to differentiate tumor′s outward invasion.The application of PVSVG CT makes it possible to develop the seminal vesicle and it can distinguish the relation between seminal vesicle and its peripheral organs at various cross sections,therefore,it has impostant value for diagnosing prostatic proliferation and carcinoma,bladder posterior wall tumor,rectal anterior wall tumor invading into seminal vesicle,and tumors or inflammatory lesions of seminal vesicle.