睾丸表皮样囊肿的超声表现及分型

Ultrasonic appearances and typing of testicular epidermoid cysts

目的探讨睾丸表皮样囊肿的声像图表现,总结其声像图特征并分型。方法回顾分析经手术病理证实的21例睾丸表皮样囊肿的声像图特征并进行分型。结果 21例睾丸表皮样囊肿患者21个病灶声像图表现不一,大致可分为5型:(1)洋葱环征型(12例):呈同心圆状高回声与低回声相间分布的层状洋葱环样排列。(2)周边钙化型(蛋壳样钙化型)(3例):周边为薄层环状强回声,内部为均质或不均质的低回声。(3)类实性团块型(3例):呈边界清楚的低回声团块,内部回声均质。(4)混合回声型(2例):内部回声混杂,以低回声为主,可见钙化及小囊样回声。(5)整体钙化型(1例):整个结节呈现强回声,后方伴有明显声影。21例肿块内部均未探及血流信号。本组超声检查与病理结果相符者20例,诊断符合率为95.2%(20/21)。结论洋葱环征型及周边钙化型为睾丸表皮样囊肿的特征性超声表现,正确识别对指导临床治疗具有重要价值。

Objective To discuss the ultrasonic appearances of testicular epidermoid cysts and summarize ultrasonic characteristics and typing.Methods The sonographic features of 21 testicular epidermoid cysts confirmed by surgery and pathological were retrospectively analyzed and typed.Results There were 21 cases of different features that could be typed into 5 ultrasonic patterns：（1）The onion ring type（12 cases） with alternating hypoechogenic and hyperechogenic concentric rings by ultrasound;（2） The perimeter calcification type（egg-shell calcification type）（3 cases） with lamellar circle hyperechogenicity around the lesion homogenic or heterogenic hypoechogenicity in the central area;（3）The similar solid type（3 cases） with well-circumscribed homogenic hypoechogenicity masses,（4） The mixed echo type（2 cases） combined with hepoechogencity inside the mass,calcification and microcyst;（5）The entirely calcified type（1 case）：the whole mass was heperechogenicity with posterior sonic shadowing.All 21 cases had no flow signal inside the lesions.The diagnostic accuracy of high-frequency ultrasonography was 95.2%（20/21）.Conclusion The onion ring type and the perimeter calcification type were typical appearances of the testicular epidermoid cysts.Correct identification was of important value in clinical therapy.