腹内型隐睾继发精原细胞瘤MSCT表现与病理分析

目的探讨腹内型隐睾继发精原细胞瘤的MSCT表现,以提高该病诊断准确性。方法分析经手术病理证实的6例腹腔内精原细胞瘤的MSCT征象,包括病变的位置、大小、生长方式,肿块长轴方向、增强供血动脉与引流静脉显示、强化模式及程度。结果6例均为单发腹内肿块,左侧2例,右侧4例。1例位于腹膜后,5例位于腹腔内。平扫肿块密度不均,呈囊实性改变,境界清楚,中央见不规则的低密度坏死区。增强后病灶实性部分均呈轻、中度强化,并呈持续性强化,坏死区未见强化。6例均行CTA检查,其中1例位于后腹膜,CTA见髂外动脉分支供血;5例位于腹腔内,CTA均显示睾丸动脉供血、睾丸回流静脉增粗。1例双侧睾丸缺如;5例单侧睾丸缺如。结论腹内型精原细胞瘤的影像表现有一定的特异性,当CTA显示供血睾丸动脉和增粗引流静脉,结合隐睾病史,可明显提高腹内型隐睾继发精原细胞瘤诊断准确性。

Expression and pathological analysis of MSCT in seminiferous cryptorchidism secondary to seminoma

Objective To investigate the MSCT performance of seminiferous cryptorchidism secondary to seminoma so as to improve the diagnostic accuracy of the disease.Methods The MSCT signs of 6 cases of intraperitoneal seminoma were confirmed by operation and pathology.The contents included the location,size and growth mode of the lesion,the long axis direction of the tumor,the enhancement of the blood supply artery and drainage vein display,the strengthening mode and degree.Results All 6 cases were single intra-abdominal masses,2 was cases on the left side and 4 cases on the right side.1 case was located in the retroperitoneum and 5 cases in the abdominal cavity.On plain scan,the mass density was uneven,showing cystic and solid chandes with clear boundary and irregular necrotic area in the center.After enhancement,the solid part of the lesion showed mild to moderate enhancement and sustained enhancement,but no enhancement was found in the necrotic area.6 cases underwent CTA examination,1 case was located in the posterior peritoneum,CTA showed branch of the external iliac artery for blood supply;5 cases were located in the abdominal cavity,CTA showed testicular artery blood supply,testicular reflux intravenous thickening.1 case was bilateral testicular insufficiency;5 cases was bilateral testicular insufficiency.Conclusion The imaging manifestations of intra-abdominal seminoma have certain specificity.When CTA shows supplying testicular artery and thickening drainage vein,combined with the history of cryptorchidism can significantly improve the diagnostic accuracy of intra-abdominal cryptorchidism secondary seminoma.