MSCT及MRI在睾丸肿瘤中的应用价值

Application Value of MSCT and MRI in Testicular Tumors

目的:探究多层螺旋CT(MSCT)及磁共振成像(MRI)在睾丸肿瘤中的应用价值。方法:回顾性选取北京丰台医院2018年3月-2021年8月收治的睾丸肿瘤患者47例。所有患者均进行MSCT及MRI检测。分析精原细胞瘤、混合型生殖细胞瘤、胚胎癌、卵黄囊瘤、畸胎瘤、淋巴瘤MSCT与MRI影像学特征。结果:精原细胞瘤MSCT平扫为圆形、类圆形或分叶状等/稍高密度肿块,多数边界清楚,密度均匀,少数瘤内中心或边缘有囊变坏死,增强扫描呈轻中度强化。MRI表现为肿瘤细胞呈结节性或分叶状实性肿块,边界清晰,可伴有囊变、坏死等。混合型生殖细胞瘤MSCT表现为高度恶性,常囊变、坏死、出血,增强扫描可呈不均匀明显多囊分隔样强化,部分可伴壁结节。MRI表现为睾丸混杂信号肿块,增强扫描,肿块明显不均匀强化。胚胎癌MSCT表现为混杂密度肿块,增强呈不均一明显强化,肿瘤周缘及内部散在明显强化区,静脉期强化减退明显。MRI表现为包膜样强化。卵黄囊瘤MSCT表现为壁厚薄不均的囊实性肿块,密度及强化不均。MRI表现为睾丸肿大,椭圆形,边界清楚,信号不均匀,T_(1)WI呈稍低信号,T_(2)WI呈高信号,增强扫描呈不均匀强化。畸胎瘤MSCT表现为囊实性肿块,密度不均匀,可见脂肪成分、弧形钙化及分隔,增强扫描实性部分轻度强化。MRI表现为睾丸不同程度肿大,呈椭圆形,肿块大小为2.1~3.5 cm,肿块边界清楚,T_(1)WI、T_(2)WI呈混杂高、低信号,增强呈不均匀轻度强化。淋巴瘤MSCT表现为类圆形肿块,界清,均匀等密度,增强扫描呈轻中度均匀强化。MRI表现为突破包膜,浸润周围肛周脂肪组织。结论:MSCT及MRI均能准确显示睾丸肿瘤临床特征,有利于术前明确肿瘤分期,确定放化疗方案,应用价值高。

Objective:To explore the application value of multi-slice spiral CT(MSCT)and magnetic resonance imaging(MRI)in the testicular tumor.Method:A total of 47 patients with testicular tumors admitted to Beijing Fengtai Hospital from March 2018 to August 2021 were selected retrospectively.MSCT and MRI testing were performed in all patients.MSCT and MRI imaging characteristics of seminoma,mixed germ cell tumor,embryonal carcinoma,yolk sac tumor,teratoma and lymphoma were analyzed.Result:On MSCT plain scan,seminoma was round,quasi round or lobulated slightly high-density mass,most of which had clear boundary and uniform density,and a few had cystic necrosis in the center or edge of the tumor.On enhanced scan,it showed mild to moderate enhancement.MRI showed that the tumor cells were nodular or lobular solid masses with clear boundaries,and could be accompanied by cystic changes and necrosis.Mixed germ cell tumor was highly malignant on MSCT,with frequent cystic changes,necrosis and hemorrhage.On enhanced scan,it can be enhanced by uneven and obvious multi cystic septa,and some of them can be accompanied by mural nodules.MRI showed a mixed signal mass of the testis.On enhanced scan,with obvious uneven enhancement of the tumor.The MSCT of embryonal carcinoma showed a mass with mixed density,and the enhancement was inhomogeneous and obvious,with obvious enhancement areas scattered around and inside the tumor,and obvious attenuation in venous phase enhancement.MRI showed capsule like enhancement.MSCT of yolk sac tumor showed a cystic solid mass with uneven wall thickness and uneven density and enhancement.MRI showed that the testis was swelling,oval,with clear boundary and uneven signal.On T_(1)WI,the signal was slightly low,and on T_(2)WI,the signal was high.On enhanced scan,the enhancement was uneven.Teratoma MSCT showed solid and cystic mass with uneven density,fat component,arc-shaped calcification and separation,and slight enhancement of solid part in enhanced scan.MRI showed that the testis was swelling to varying degrees,oval in shape,the size of the mass was 2.1-3.5 cm,the boundary of the mass was clear,the T_(1)WI and T_(2)WI showed mixed high and low signals,and the enhancement showed uneven light enhancement.MSCT of the lymphoma showed a quasi circular mass with clear boundary and uniform density.The enhanced scan showed mild to moderate uniform enhancement.MRI showed a breakthrough of the capsule and infiltration of the surrounding perianal adipose tissue.Conclusion:MSCT and MRI can accurately display the clinical characteristics of testicular tumors,which is conducive to the preoperative determination of tumor staging,and the determination of radiotherapy and chemotherapy programs,with high application value.