射精管梗阻的MRI诊断及病因分析

MRI diagnosis of ejaculatory duct obstruction

目的探讨射精管梗阻的MRI表现。方法回顾性分析2003年1月至2010年12月期间行经尿道射精管口电切术治疗的射精管梗阻患者106例，其中16例术前接受了射精管MR检查，分析其MRI表现。结果16例中，MR图像上发现射精管囊肿5例，大小为4mm×4mm×7mm-4mm×4mmX9mm，位于中线旁；射精管扩张7例，位于中线旁，内径5-30mm。增强扫描2例射精管管壁明显强化。前列腺Muller囊肿并射精管及精囊扩张4例，囊肿位于中线，呈倒水滴状，大小为4mm×5mm×6mm-34mm×35mm×44mm。手术中所见与MR所见一致。结论射精管梗阻最常见的表现是射精管扩张和射精管囊肿。

Objective To explore the MRI features of ejaeulatory duct obstruction. Methods During January 2003 to December 2010, transrectal ultrasonography （TRUS） was performed for 106 patients and underwent surgical treatment for ejaculatory duct obstruction. Among them, 16 patients underwent MRI examination. The MRI features of ejaculatory duct obstruction in these patients were summarized. Results Ejaculatory duct cysts, ranging in size from 4 mm x 4 mm x 7 mm to 4 mm x 4 mm x 9 mm and locating in the paramedian line, were detected in 5 of the 16 patients; ejaculatory duct dilation located in the paramedian line was detected in 7 patients, with the internal diameter of 5 to 30 mm. After contrast injection, significant enhancement of the wall of the ejaculatory duct was observed in 2 patients. Mullerian duct cysts complicated with dilated ejaculatory duct and seminal vesicles were detected in 4 patients, in whom the cysts were located in the median line, ranging in size from 4 mm×5 mm×6 mm to 34 mm×35 mm×44 mm, with inverted teardrop shaped pointing toward the seminal colliculus. Conclusion The most common MRI features of ejaculatory duct obstruction are ejaculatory duct dilation and ejaculatory duct cysts.