56例附睾结核CT影像表现分析

为了解附睾结核的CT影像学特征，笔者收集了2020年9月1日至2021年10月31日昆明市第三人民医院收治的经病理组织学、细菌学或实验性抗结核治疗有效的56例附睾结核患者资料进行分析。结果发现，56例附睾结核患者的中位年龄为42岁，有阴囊肿痛症状者37例(66.1%),其中合并阴囊皮肤窦道形成者9例(16.1%);合并肺结核、肾结核、鞘膜积液、睾丸受累者分别为29例(51.8%)、26例(46.4%)、24例(42.9%)、15例(26.8%)。CT表现为附睾增粗56例(100.0%)、病灶多发34例(60.7%)、单侧附睾受累32例(57.1%)、附睾钙化8例(14.3%);CT增强扫描门静脉期附睾病变仅结节状强化、仅环状强化及同时有二者表现分别为23例(41.1%)、19例(33.9%)、14例(25.0%)。认为附睾结核患者多有阴囊肿痛，可合并肺结核及肾结核，CT扫描多为单侧附睾受累、病灶多发，增强扫描呈结节状或环状强化，具有一定CT影像学特征。

CT imaging of 56 cases of epididymal tuberculosis

To understand the CT imaging features of epididymal tuberculosis, the author analyzed 56 patients with epididymal tuberculosis admitted to Kunming Third People’s Hospital from September 1, 2020 to October 31, 2021, who were diagnosed with pathology, bacteriology or effective with anti-tuberculosis treatment.The results revealed the median age of 56 patients with epididymal tuberculosis was found to be 42 years old, and 37 cases (66.1%) had symptoms of scrotal swelling and pain. Among them, 9 cases (16.1%) were combined with scrotal skin sinus tract formation. The number of cases with combined pulmonary tuberculosis, renal tuberculosis, syringomyelia and testicular involvement were 29 (51.8%), 26 (46.4%), 24 (42.9%) and 15 (26.8%).CT showed the epididymis was thickened in 56 cases (100.0%), multiple lesions in 34 cases (60.7%).The epididymis was involved unilaterally in 32 cases (57.1%), and the epididymis was calcified in 8 cases (14.3%). The number of cases with only nodular enhancement, only rim enhancement and both were 23 (41.1%), 19 (33.9%) and 14 (25.0%), respectively, on CT-enhanced scans of epididymal lesions in the portal vein phase. It is believed that patients with epididymal tuberculosis mostly have scrotal swelling and pain, and can be combined with pulmonary and renal tuberculosis. CT scans mostly show unilateral epididymal involvement with multiple lesions and nodular or rim enhancement on enhancement CT scans, which have certain CT imaging characteristics.