顽固性血精症远端生殖道区域MRI影像学分析

MRI characteristics of distal genital tract region in refractory hematospermia

目的探讨MRI在顽固性血精症病因诊断中的应用价值。方法回顾性分析2014-2018年重庆市中医院36例既往诊断的顽固性血精患者(病例组)和30例无任何泌尿生殖系统疾患患者(对照组)临床资料,重点分析双侧精囊及射精管区域的MRI影像学特征。结果病例组患者MRI结果显示,36例患者均显示精囊腺信号异常,其中精囊结石2例,前列腺小囊囊肿13例,射精管囊肿2例,苗勒囊肿3例,精囊囊肿3例,射精管扩张11例,2例仅表现精囊腺出血信号,无囊性病变、结石、肿瘤等征象。病例组左侧精囊腺宽度为(2.01±0.07)cm,右侧囊腺宽度为(2.11±0.13)cm,明显宽于对照组[(1.67±0.09)cm vs.(1.69±0.10)cm],差异有统计学意义(P<0.01);而两组精囊长度无明显差异。结论MRI检查可有效显示远端生殖道区域的病变,对于顽固性血精症患者的病因诊断和临床治疗具有重要指导价值。

Objective To evaluate the application value of magnetic resonance imaging(MRI)in persistent and refractory hematospermia.Methods The MRI imaging characteristics of the distal genital tract region in 36 patients with intractable hematospermia(the case group)and 30 controls(the control group)were retrospectively analyzed.Results All of the 36 patients showed the abnormal signal in seminal vesicle.And there were 2 cases of seminal vesicle stone,13 cases of prostate vesicle cyst,2 cases of ejaculatory duct cyst,3 cases of mullerian cyst,3 cases of seminal vesicle cyst,11 cases of ejaculatory duct dilation,2 cases of seminal vesicle hemorrhage signal only.Compared with the controls,the left and right width of seminal vesicle[(2.01±0.07)cm and(2.11±0.13)cm]in the case group all increased obviously[(1.67±0.09)cm vs.(1.69±0.10)cm](P<0.01),but the length of seminal vesicle did not differ obviously.Conclusion MRI examination can clearly show the lesions in the distal genital tract region,which has important reference value for etiological diagnosis and clinical treatment of refractory hematospermia.