睾丸精原细胞瘤的MSCT及MRI表现

目的 :分析睾丸精原细胞瘤的MSCT、MRI表现,以提高对该病的认识。方法 :回顾性分析9例经手术病理证实的睾丸精原细胞瘤的MSCT、MRI表现,观察病灶的形态特征、密度、信号强度及强化特点,5例行MSCT检查,2例行MRI检查,2例同时行MSCT和MRI检查。结果:精原细胞瘤MSCT主要表现为密度相对均匀,增强扫描后肿瘤轻至中度强化。MRI主要表现为卵圆状或分叶状,信号均匀,T_2WI示更低信号条带状样分隔,增强扫描时分隔强化程度高于其他实质部分。结论 :睾丸精原细胞瘤影像学表现有一定特征性,MSCT、MRI检查对睾丸精原细胞瘤的诊断与鉴别诊断有很大价值。     

睾丸精原细胞瘤的MRI诊断与鉴别诊断

目的 :分析睾丸精原细胞瘤的MRI表现,提高对该病的影像学认识。方法 :回顾性分析11例经手术病理证实的阴囊内睾丸精原细胞瘤患者的MRI表现,观察病灶的形态特征、信号强度,并与病理形态学表现进行对照。结果:精原细胞瘤的MRI平扫主要表现为结节样或分叶状,T2WI呈低信号,相对均匀。增强扫描病灶边缘及内部可见低信号纤维血管分隔早期明显强化,动态增强曲线表现为平台型;肿瘤实质部分中度强化,强化程度低于肿瘤分隔,动态增强曲线表现为速升速降型。病灶内有出血、坏死时信号混杂,增强扫描不均匀强化。结论:T2WI病灶均匀低信号及纤维血管间隔早期明显强化是睾丸精原细胞瘤的显著特征,MRI对该病的诊断具有重要意义。     

睾丸精原细胞瘤MRI表现

目的 分析睾丸精原细胞瘤的MRI影像表现,以提高睾丸精原细胞瘤的诊断水平.方法 回顾性分析经手术病理证实的14例睾丸精原细胞瘤MRI表现.结果 睾丸精原细胞瘤MRI表现呈团块状或结节状,边界清晰,T2WI呈均匀短T2信号,其内可见低信号分隔,扩散加权成像(DWI)扩散受限呈高信号,表观扩散系数(ADC)图呈低信号,增强后病变实质呈轻度强化,分隔强化较实质相对明显,时间-信号强度曲线(TIC)为缓慢上升型.结论 睾丸精原细胞瘤MRI表现具有一定特征性,对病变诊断具有重要诊断价值.     

睾丸精原细胞瘤的低场MR诊断

目的 探讨睾丸精原细胞瘤的MRI表现,以提高对该病的影像学认识.资料与方法 搜集12例经手术病理证实的睾丸精原细胞瘤,左侧5例,右侧7例;发病年龄17～54岁,平均36.8岁;着重分析肿瘤的好发年龄、部位、MRI信号特点、肿瘤强化情况.结果 睾丸精原细胞瘤MRI表现具有以下特点:(1)肿瘤多呈类圆形或分叶状实性肿块,边界清晰,无完整包膜,个别肿瘤较大可替代整个睾丸,内部伴有囊变、出血.(2)肿瘤实质T1WI 呈等或稍低信号,与正常睾丸组织不能区分,T2WI呈均匀一致低信号,与正常睾丸组织显著高信号对比鲜明.(3)增强扫描肿瘤无强化或轻度强化,纤维血管分隔明显强化.(4)白膜对肿瘤邻近扩散有阻隔作用.结论 睾丸精原细胞瘤MRI表现具有一定特征性,结合其临床表现,术前MRI检查有助于定性诊断.     

睾丸精原细胞瘤MRI表现

目的 分析睾丸精原细胞瘤MRI表现.方法 18例睾丸精原细胞瘤均行1.5T MRI平扫,其中12例行增强(0.1 mmol/kg)扫描.所有病例均经病理确诊.结果 平扫6例T1WI呈等信号,12例T1WI呈稍低信号,17例T2WI呈低或稍低信号,1例异位到盆腔睾丸精原细胞瘤T2WI呈稍高信号;精原细胞瘤的信号在T2WI与正常睾丸实质差别明显,为边缘清晰的实性肿块,信号不均匀,病变出血、坏死少见,8例合并鞘膜积液.增强扫描显示5例轻度强化,2例较明显强化,5例呈不规则网状强化.结论 MRI对诊断睾丸肿瘤有较高的临床价值.     

儿童睾丸内胚窦瘤的CT和MRI特征分析

目的探讨儿童睾丸内胚窦瘤的CT及MRI特征,提高诊断的准确率。方法回顾性分析经手术病理证实的20例儿童睾丸内胚窦瘤的CT和MRI资料。其中行CT检查4例,3例行增强检查;行MRI检查16例,11例行增强检查。结果 20例病灶均单发,左侧睾丸12例,右侧睾丸8例,呈圆形或类圆形,边界清晰17例,模糊3例。CT平扫病灶均呈混杂密度包块,MRI平扫病灶T1WI呈等、等低或混杂信号;T12WI呈等、等高或稍高信号,CT及MRI增强扫描肿瘤实质部分不均匀强化明显。结论儿童睾丸内胚窦瘤的CT和MRI表现特殊,综合分析有助于提高术前诊断准确率。     

睾丸生殖细胞肿瘤的MRI诊断

目的：探讨睾丸生殖细胞肿瘤的 MRI 表现,提高对该疾病的 MRI 诊断水平。方法回顾性分析经手术病理证实的25例睾丸生殖细胞肿瘤患者临床及 MRI 资料,所有病例均行 MRI 平扫,其中16例行动态 MRI 增强扫描。利用 MRI 对睾丸肿瘤的大小、形态、信号特点、毗邻关系、强化方式及肿瘤血管情况进行评估,并与病理对照。结果25例睾丸生殖细胞肿瘤中,精原细胞瘤10例,其中 T2 WI 呈均匀低信号8例,稍低信号2例,增强扫描轻度结节样强化5例,明显均匀强化2例,其中4例可见纤维间隔强化;卵黄囊瘤4例,T1 WI 呈等低信号,T2 WI 呈稍高信号,增强扫描后肿瘤呈渐进式强化;成熟型畸胎瘤、表皮样囊肿、混合性生殖细胞肿瘤各3例,T1 WI 呈混杂低信号,T2 WI 呈混杂高信号;胚胎性癌2例,T1 WI 呈等低信号,T2 WI 呈混杂低信号,其内可见出血信号,增强扫描呈分隔强化。结论MRI 对睾丸生殖细胞肿瘤诊断正确率较高,对其病理分型、分期及鉴别诊断具有重要价值。     

外周恶性神经鞘膜瘤的影像学表现

目的:总结分析外周恶性神经鞘膜瘤的影像学表现,提高鉴别诊断能力。方法:回顾性分析11例经手术或病理证实的恶性神经鞘膜瘤的影像学表现,并与手术病理对照分析,11例中行CT检查3例,行MRI检查4例,CT和MRI均检查4例。结果:CT平扫表现为等、低混合密度软组织肿块影,形态不规则,病灶边缘较光整2例,边缘毛糙5例。CT增强扫描呈不均匀强化,坏死区不强化,网格样强化2例,不均匀强化5例。T1WI呈等、略低信号,内见局灶性长T1信号影;T2WI序列以略高信号为主,内见局灶性长T2信号,周围软组织见片状浸润高信号;MRI增强扫描呈不均匀强化。结论:恶性外周神经鞘膜瘤的CT和MRI表现具有一定的特征性。     

周围神经鞘瘤的CT和MRI分析

目的:分析周围神经鞘瘤的CT和MRI征象及病理组织学表现.方法:回顾性分析我院经手术病理证实的周围神经鞘瘤30例的CT和MRI征象及病理表现.结果:病变发生在颈部10例、胸部6例、腹部7例(含胃部4例)、四肢7例.30例周围神经鞘瘤中25例为良性,5例为恶性.20例行CT检查,其中17例良性病灶平扫密度较均匀,4例可见点状钙化灶,增强扫描病灶呈轻至中度强化,3例恶性病灶瘤体巨大,囊变、坏死多发,增强扫描强化不均匀.10例周围神经鞘瘤行MRI检查,MRI表现:T1WI病灶呈等或稍低信号,T2 WI呈高信号,增强扫描不均匀强化,10例病灶中,2例为恶性周围神经鞘瘤并伴淋巴结转移.结论:周围神经鞘瘤的CT和MR1表现具有特征性,CT和MRI能准确地显示肿瘤形态、部位、内部结构及与邻近结构的关系,对诊断有重要帮助,对手术治疗具有重要指导作用.     

节细胞神经瘤的CT和MR诊断

目的:研究节细胞神经瘤的CT和MRI表现特点及其诊断价值。方法:对9例节细胞神经瘤行CT和MRI检查,9例均做CT平扫加增强,8例患者行MRI,其中4例MRI增强。所有病例均经手术病理证实。结果:6例位于腹膜后,2例位于纵隔,1例位于颈部,表现为椭圆形,所有病变边缘都非常锐利。在CT平扫上均为低至中等密度,在MRI上T1WI表现为低信号,T2WI上呈非均匀高信号;增强后表现为轻度或不均匀的中等度强化。结论:CT与MRI相结合能比较全面准确地反映节细胞神经瘤的特性,是目前诊断该病较为理想的方法。     

睾丸肿瘤的CT诊断

目的:探讨睾丸肿瘤的CT表现及诊断价值。方法:回顾性分析12例睾丸肿瘤的CT资料,与手术病理对照。结果:CT图像上12例13个病变睾丸均不同程度增大,边界多数较清。其中9例精原细胞瘤呈实质性改变为主,可见不同程度低密度影,轻度强化,3例腹内型尚可见丰富供血血管,1例2个淋巴瘤,1例胚胎性癌伴内胚窦癌,1例胚胎性癌为表现为囊实性肿块混杂密度,呈环形强化或强化较明显。结论:CT对睾丸肿瘤的检出、分型诊断和分期等有一定价值,对腹内型睾丸肿瘤的鉴别诊断有重要意义。     

A case of testicular malignant lymphoma with extension to the epididymis and spermatic cord.

Findings of magnetic resonance imaging (MRI) in a case of testicular lymphoma are presented. The tumor was lower intensity than the normal testis on T2-weighted images. Coronal images clearly showed the tumor extending to the spermatic cord. Compared with seminoma, lymphoma more often invades the epididymis and spermatic cord. MRI is a useful method for differentiating between testicular lymphoma and seminoma because it clearly shows tumor extension to the epididymis and spermatic cord.     

睾丸精原细胞瘤的MSCT诊断

目的:探讨睾丸精原细胞瘤的MSCT影像特点。方法:回顾性分析有完整CT平扫及增强资料、经病理证实的9例睾丸精原细胞瘤的MSCT表现。结果:9例中5例为腹部隐睾肿瘤、4例为阴囊上方肿瘤。主要CT表现为:肿瘤有完整或不完整包膜,增强后有8例呈轻~中度分隔样强化,腹部5例腹股沟管内精索缺失,4例阴囊上方肿瘤,精索伴行血管增粗,血管成像显示5例腹部及3例阴囊内肿瘤显示为同侧睾丸动脉供血。伴同侧肾脏、精索及精囊腺缺如1例,伴两侧输尿管下端囊肿1例,伴子宫样结构(假二性体)1例,睾丸下降固定术后两年恶变1例。结论:睾丸精原细胞瘤有一定影像学特征性,结合MSCT血管成像所示睾丸动脉供血及伴随泌尿生殖系其它发育异常可作出定性诊断。     

Late relapse of testicular seminoma in the posterior mediastinum

Patients with testicular seminoma are usually cured if they survive disease-free for 5 years after therapy. Late relapse can also occur but is rare. In particular, relapse of testicular seminoma in the form of a large mediastinal mass is extremely rare. We present here a 37-year-old man with a late relapse of a large testicular seminoma in the posterior mediastinum, encasing the descending thoracic aorta, and compressing the left atrium and left main bronchus on computed tomography (CT) and positron emission tomography (PET).     

Invasion of the inferior vena cava by testicular seminoma: demonstration by computed tomography and venography

Involvement of the inferior vena cava (IVC) by testicular neoplasms is unusual and often clinically unsuspected. We present a patient with testicular seminoma that involved the IVC secondarily and caused multiple pulmonary emboli requiring the placement of a caval filter. The radiographic features of this phenomenon are presented with special emphasis on the computed tomographic (CT) appearance of caval thrombosis and pulmonary embolus. The characteristically low density lymphadenopathy of seminoma may obscure the diagnosis of caval thrombosis on CT. Although the findings are nonspecific, tumor invasion of the IVC should be suspected in all patients with testicular neoplasms who demonstrate caval thrombosis radiographically.     

Invasion of the inferior vena cava by testicular seminoma: Demonstration by computed tomography and venography

Involvement of the inferior vena cava (IVC) by testicular neoplasms is unusual and often clinically unsuspected. We present a patient with testicular seminoma that involved the IVC secondarily and caused multiple pulmonary emboli requiring the placement of a caval filter. The radiographic features of this phenomenon are presented with special emphasis on the computed tomographic (CT) appearance of caval thrombosis and pulmonary embolus. The characteristically low density lymphadenopathy of seminoma may obscure the diagnosis of caval thrombosis on CT. Although the findings are nonspecific, tumor invasion of the IVC should be suspected in all patients with testicular neoplasms who demonstrate caval thrombosis radiographically.     

Intrathoracic manifestations of metastatic testicular seminoma: a comparison of chest radiographic and CT findings

The chest radiographs and CT scans of 200 patients with pure testicular seminoma were reviewed. The radiographs showed evidence of intrathoracic metastatic disease in 25 patients (12.5%). Of these, 17 had an abnormal mediastinal contour, seven had pulmonary metastases, five had pleural effusions, and two had discrete pleural masses. CT showed evidence of intrathoracic metastatic disease in 30 patients (15%). This included mediastinal nodal enlargement in 21, pulmonary metastases in 12, pleural effusions in six, and pleural masses in two. CT not only showed disease in five patients with normal chest radiographs, but also showed additional sites of disease in four other patients with abnormal chest radiographs. The results suggest that mediastinal nodal enlargement is the most common intrathoracic manifestation of metastatic testicular seminoma. CT is more accurate than chest radiography in the detection of metastatic seminoma in the chest and defines the extent of metastatic disease more precisely.     

DWI及常规MRI征象对睾丸恶性肿瘤的诊断价值

目的 探讨DWI及常规MRI征象对睾丸恶性肿瘤的鉴别诊断价值.方法 选取经病理证实的睾丸恶性病变46例,其中精原细胞瘤25例,非精原细胞瘤13例,淋巴瘤8例,均行MRI平扫及DWI扫描.2位医师双盲法进行影像征象分析及ADC值测量,一致性的分析运用Kappa检验及组内相关系数(ICC);计数资料的差异性分析运用x2检验...     

腹内未降睾丸巨大纯精原细胞瘤六例CT资料分析

目的 探讨螺旋CT对腹内未降睾丸巨大纯精原细胞瘤的诊断价值.方法 回顾性分析经手术病理证实的6例巨大的腹内未降睾丸纯精原细胞瘤的螺旋CT表现.结果 6例肿块长轴与同侧肾下极和腹股沟内环的连线一致.供血动脉均为同侧睾丸动脉,5例显示睾丸静脉引流.同侧睾丸及精索未显示,2例肿块尾端见未退化的睾丸引带.同侧肾脏受压上移.肿块呈囊实混合型,内侧坏死明显,其内可见条状纤维血管分隔,实性部分轻度均匀强化.所有肿块内未见钙化或脂肪.结论 螺旋CT是腹内巨大精原细胞瘤术前定位定性诊断的一种有用的影像手段.