睾丸原发肿瘤的MSCT诊断(附10例分析)

目的探讨多层螺旋CT在睾丸原发肿瘤的诊断、鉴别诊断及分期中的价值。方法回顾性分析经手术病理证实的10例睾丸原发肿瘤的CT表现和临床资料。结果 CT检出全部10例肿瘤,其中精原细胞瘤5例(1例合并胚胎性癌),混合型生殖细胞肿瘤、胚胎性癌、畸胎瘤、弥漫大B细胞淋巴瘤、横纹肌肉瘤各1例。4例精原细胞瘤与1例淋巴瘤密度较均匀,增强后均匀强化,1例精原细胞瘤囊变;1例畸胎瘤平扫见钙化及脂肪密度,增强后软组织部分明显强化;1例胚胎性癌、1例混合性生殖细胞瘤和1例横纹肌肉瘤平扫密度不均,不均等强化。1例混合型生殖细胞瘤LDH升高,1例胚胎性癌与1例畸胎瘤AFP、β-HCG显著升高,仅1例精原细胞瘤LDH、β-HCG轻度升高。结论多层螺旋CT增强扫描对睾丸肿瘤的检出、诊断和临床分期具有重要的价值,结合临床资料综合分析,对各种睾丸肿瘤鉴别诊断也有一定意义。

Multi-slice CT Diagnosis of Primary Testicular Tumor

Objective To evaluate the value of Multi-slice CT in the diagnosis and differential diagnosis and staging of primary testicular tumors. Methods CT findings and clinical data of 10 cases with testicular tumors that proved surgically and pathologically were retrospectively analyzed. Results CT could correctly detect all of the 10 tumors including seminomas（n5, 1 case cmplicated embrynal carcinoma）, mixed genminoma （n=1）, embryonal carcinoma（n=1）, teratoma（n=1）, diffuse large B-cell lymphoma（n=1）, and rhabdomyosarcoma（n=1）. The CT features inclued homogenous enhancement （seminomas and lymphoma）, inhomogenous enhancement（teratoma, embryonal carcinoma, mixed geminoma and rhabdomysarcoma）, cystic change（seminoma）, calcification and fat density（teratoma）. The features of laboratory tests had LDH on higher level（mixed geminama）, significantly increased AFP β-HCG（embryonal carcinoma and teratoma） and slightly increased LDH and β- HCG（seminoma）. Conclusion Combined with clinical information, MSCT has a very important value not only in the diagnosis and clinical staging￡？but also in differential diagnosis of testicular tumors.