MRI对睾丸良性病变诊断价值

The Diagnostic Values of MRI in Benign Testicular Lesions

目的探讨睾丸良性病变的MRI表现,提高其影像诊断水平。方法对25例术后病理证实为睾丸良性病变的MRI检查资料进行回顾性分析。结果睾丸炎7例,表现为患侧睾丸肿胀,T_(1)WI信号减低,T_(2)WI信号不同程度增高,增强扫描明显不均匀强化。其中3例合并睾丸脓肿,增强扫描脓肿壁明显强化;睾丸结核8例,3例表现为多发“粟粒”样结节影,3例合并脓肿,2例呈渗出样改变。间质细胞瘤2例,T_(1)WI呈稍低信号,T_(2)WI呈低信号,增强扫描持续渐进性强化;表皮样囊肿6例,T_(1)WI呈低信号,5例T_(2)WI呈不均匀高信号,1例呈“洋葱皮”外观,增强扫描均未见强化。青春期前型畸胎瘤1例,内见成熟脂肪信号,增强扫描实性成分明显不均匀强化;黏液性囊性肿瘤1例,呈多房囊状液体信号影,增强扫描囊壁及分隔轻度强化。结论MRI是一种较好的睾丸疾病检查方法,能术前明确睾丸良性病变,为临床治疗方案制定提供指导,但最终确诊仍依靠病理。

Objective To investigate the MRI features of benign testicular lesions,improving diagnostic accuracy.Methods MRI examination data of 25 cases of benign testicular lesions that were confirmed by surgery and pathology were analyzed retrospectively.Results 7 cases of orchitis,showed testicular swelling on the affected side.The signal decreased on T_(1)WI and increased on T_(2)WI to varying degrees.The contrast enhancement showed vividly inhomogeneous enhancement.3 cases were complicated with testicular abscesses and showed vivid enhancement in the abscess wall.8 cases of testicular tuberculosis.3 cases showed multiple"miliary"nodules in the testis.3 cases combined with abscesses.2 cases showed transudatory appearance.2 cases of Leydig cell tumors,showed sightly low signal on T_(1)WI,low signal on T_(2)WI,and continuously progressive enhancement.6 cases of epidermoid cysts,showed low signal on T_(1)WI.On T_(2)WI,5 cases showed inhomogeneously high signal and 1 case showed an"onion skin-like"appearance.All cases have on enhancement during the contrast enhancement scan.1 case of forepubertal-type teratoma.There was signal of mature fat in the lesion.During the contrast enhancement scan,the solid component showed vividly inhomogeneous enhancement.1 case of mucinous cystadenoma,showed a multilocular and cystic fluid signal.The cystic wall and septa showed mild enhancement during the contrast enhancement scan.Conclusion MRI is a better examination method of testis,which can definite the benign testicular lesion before the operation and give guidance for forming clinical therapeutic schedule.While the ultimate diagnosis still depends on pathology.