睾丸原发肿瘤的CT诊断及鉴别诊断(附50例分析)

CT diagnosis and differential diagnosis of primary testicular tumors(analysis of 50 cases)

目的探讨睾丸原发肿瘤的CT表现及诊断价值。方法回顾性分析50例七类睾丸肿瘤的临床及CT表现,并与手术病理对照。结果 CT图像上50例51个病变睾丸肿大,呈软组织密度,边界多数较清。其中精原细胞瘤24例,轻中度均匀强化,可坏死囊变,偶见钙化;混合性生殖细胞瘤6例,明显不均匀多囊样强化,可伴壁结节;成熟型囊性畸胎瘤4例,呈脂肪密度;未成熟型畸胎瘤4例,呈混杂软组织密度;胚胎性癌5例,偶见包膜样强化及钙化;卵黄囊癌6例,不均匀多囊、结节、片状强化;弥漫性大B细胞淋巴瘤1例,双侧发病,实性均质。结论不同病理类型睾丸原发肿瘤的CT表现有一定特点,术前CT检查可为临床诊疗提供重要参考。

Objective To investigate the CT appearance of different types of primary testicular tumors and to explore its value for differential diagnosis .Methods CT images of 50 cases with pathologically confirmed primary testicular tumors were retrospectively analyzed .Results All 51 testicular lesions were soft tissue masses with clear boundaries on CT ima-ges .Twenty-four spermocytoma enhanced mildly-to-moderately with occasional cystic degeneration ,necrosis and calcifica-tion .Six mixed germ cell tumor enhanced heterogeneously with obviously uneven polycystic degeneration ,and sometimes mural nodules .Four mature cystic teratoma were fat-like homogeneous masses .Four immature teratoma were inhomoge-neous masses with mild enhancement .Five embryonal carcinoma enhanced unevenly and significantly ,with occasionally envelope-like enhancement and calcification .Six yolk sac tumor enhanced significantly and inhomogeneously with common-ly cystic degeneration and nodular or flake enhancement .One lymphoma was homogeneous soft tissue masses on bilateral testes .Conclusion CT examination is important in the preoperative diagnosis of different types of primary testicular tumors .