睾丸混合性生殖细胞瘤的多模态超声特征分析

Multimodal ultrasound features analysis of mixed germ cell tumor of the testis

目的探讨睾丸混合性生殖细胞瘤(TMGCT)的多模态超声声像图特征及临床表现。方法选取2013年6月至2023年12月在郑州大学第一附属医院经病理证实的44例TMGCT患者,回顾性分析其声像图资料,包括灰阶超声、彩色多普勒超声、超声造影和弹性成像。结果44例患者年龄(24.65±9.59)岁,肿瘤最大径(50.77±23.31)mm;灰阶超声显示,34例(77.27%)超声表现为囊实性混合回声,7例(15.91%)为实行不均质低回声,1例(2.27%)为实性均匀低回声,1例(2.27%)实性不均质高回声,1例(2.27%)实性不均质中等回声;彩色多普勒超声显示,12例(27.27%)为Ⅰ级血流信号,20例(45.46%)为Ⅱ级血流信号,12例(27.27%)为Ⅲ级血流信号;超声造影显示,3例患者总体表现均为“快进快退”;弹性成像显示,2例病灶压力应变式弹性评分分别为3分、4分。结论多模态超声诊断TMGCT具有一定的影像特征,但总体较为复杂,结合血清肿瘤标志物及临床资料,可明显提高TMGCT的诊断及其鉴别诊断效果。

Objective To explore the multimodal ultrasound sonographic features and clinical manifestations of testicular mixed germ cell tumors(TMGCT).Methods Forty-four patients with pathologically confirmed mixed germ cell tumors of the testis were selected from June 2013 to December 2023 in he First Affiliated Hospital of Zhengzhou University,and their sonographic data were retrospectively analyzed,including grayscale ultrasound,color Doppler ultrasound,ultrasonography and elastography.Results The age of 44 patients was(24.65±9.59)years,and the maximum diameter of the tumors was(50.77±23.31)mm.Gray-scale ultrasound showed that 34 cases(77.27%)had mixed cystic-solid echoes on ultrasound,7 cases(15.91%)practiced inhomogeneous hypoechoicity,1 case(2.27%)had solid homogeneous hypoechoicity,1 case(2.27%)had solid inhomogeneous hypoechoicity,and 1 case(2.27%)had solid heterogeneous moderate echo.Color Doppler ultrasound showed that 12 cases(27.27%)had gradeⅠflow signal,20 cases(45.46%)had gradeⅡflow signal,and 12 cases(27.27%)had gradeⅢflow signal.Ultrasonography showed that the overall performance of the 3 patients was"fast in and out".Elastic imaging showed that the pressure-strain elasticity scores of the lesions in 2 cases were 3 and 4,respectively.Conclusion Multimodal ultrasound diagnosis of testicular mixed germ cell tumor has certain imaging characteristics,but the overall complexity,combined with serum tumor markers and clinical history,can significantly improve the diagnosis of TMGCT and its identification.