睾丸肾上腺残基瘤的超声图像特征

Ultrasonographic characteristics of testicular adrenal rest tumors

目的分析睾丸肾上腺残基瘤(TART)的超声图像特征,以提高超声诊断价值。方法收集2018年1月至2022年8月在郑州大学附属儿童医院确诊为TART的10例男性患者的临床资料,年龄6~26岁,均有多年先天性肾上腺皮质增生症(CAH)病史,总结超声图像特点。结果10例患者均累及双侧睾丸,超声检查共发现病灶23个,均呈局灶性生长,其中16个位于睾丸门,7个位于睾丸纵隔旁;睾丸体积正常6例(60.0%),睾丸体积增大4例(40.0%);睾丸纵隔清晰显示9例(90.0%);23个(100.0%)病灶均边界清晰无包膜,其中低回声20个(87.0%),等回声3个(13.0%);病灶形态不规则16个(69.6%),病灶呈类圆形7个(30.4%);血供丰富14个(60.9%),血供稀少9个(39.1%)。结论TART以双侧睾丸受累为主,睾丸门或睾丸纵隔旁的低回声区为其特征性超声表现,结合CAH病史可做出确切诊断。

Objective To analyze the ultrasonic image characteristics of testicular adrenal rest tumors(TART),in order to improve the diagnostic value of ultrasonography.Methods The clinical data of 10 male patients aged 6 to 26 years who were diagnosed as TART with a history of congenital adrenal hyperplasia(CAH)for many years in the Children's Hospital Affiliated to Zhengzhou University from January 2018 to August 2022 were collected.The characteristics of ultrasound images were summarized.Results All the 10 cases involved bilateral testis.Ultrasonography showed 23 focal lesions,16 of which were located in the testis hilum and 7 were located next to the mediastinum of the testis.Testicular volume was normal in 6 cases(60.0%)and enlarged in 4 cases(40.0%).The testis mediastinum was clearly displayed in 9 cases(90.0%).All the 23 lesions(100.0%)had clear boundary without envelope,of which 20 were hypoechoic(87.0%)and 3 were isoechoic(13.0%);there were 16 lesions with irregular shape(69.6%)and 7 lesions with quasi-circular shape(30.4%);there were 14 lesions with abundant blood supply(60.9%)and 9 lesions with scarce blood supply(39.1%).Conclusions TART is mainly characterized by bilateral testicular involvement.The low echo area of porta testicle or mediastinum of testicle is the characteristic ultrasonography of TART.The diagnosis of TART can be made in combination with history of CAH.