附睾结核的MRI 诊断价值

目的 分析附睾结核的MRI 表现,总结其MRI 的诊断要点.方法 对8 例经病理确诊为附睾结核的MRI 进行回顾性分析,重点分析其部位、形态、MRI 信号、强化方式及泌尿生殖系其他部位的情况.结果 8 例患者中2 例为局限于附睾附睾头的单发实性圆形小结节灶,6 例累及整个附睾弥漫性或多发形态不规则结节灶;4 例为实性病灶,2 例为囊实性病灶;8 例病灶实性部分T1WI 均呈等信号,T2WI 均呈低信号,囊性部分T1WI 呈低信号,T2WI 呈高信号.增强扫描8 例病灶中T2WI 呈低信号实性部分均明显强化.8 例患者中伴有泌尿系、睾丸、前列腺、精囊腺、肺结核分别为4 例、4 例、2 例、1 例及1 例.结论 附睾结核常伴发其他泌尿生殖系结核,典型的附睾结核多累及整个附睾,表现为在T2WI 呈低信号的实性病灶,且增强扫描明显强化,此MRI 特异性表现可以对附睾结核进行准确定位和早期诊断.

Application value of MRI in diagnosis of tuberculous epididymitis

Objective To analyse MRI manifestation and diagnosis value of tuberculous epididymitis.Methods Eight patients with tuberculous epididymitis which had been confirmed by clinical diagnosis were analyzed retrospectively.The emphasis was to analyse the lesion location,sharpness,features of signal intensity,contrast enhancement,and other genitourinary tuberculosis.Result Two in 8 patients display single nodule limited in epididymis which were round or oval,solid,iso-signal intensity on T1WI,low signal intensity on T2WI.Six patients display whole epididymis lesion which were solid(4/6) or cystic-solid(2/6).All of the solid part represented low signal intensity on T2WI.On contrast enhancement all of low signal intensity part on T2WI showed obvious enhancement or edge enhancement.Four of them could be seen testis tuberculosis,4 of them showed tuberculosis of prostate,2 patients had seminal vesicle tuberculosis,1 patient showed tuberculosis of urinary system,and 1 patient had pulmonary tuberculosis.Conclusions Epididymis is well demonstrated on MRI.Tuberculous epididymitis has special pathogenic pattern and shows low signal intensity on T2WI and obvious enhancement.When combining with other sign of genitourinary,MRI can make an efficient and early diagnosis of Tuberculous epididymitis.