睾丸病变的CT诊断和病理学研究

目的 探讨CT在睾丸占位性病变诊断及鉴别诊断中的价值.方法 13例睾丸占位性病变,11例经临床肿瘤标记物检查如甲种胎儿蛋白(AFP)和人绒毛膜促性腺激素.CT扫描层厚、层距各2 mm,平扫加60%优维显70 ml静脉团注后增强扫描.螺旋CT多平面重建采用GE LightSpeedl6图像后处理工作站.结果 13例病例均经手术病理证实,其中精原细胞瘤3例,内胚窦瘤1例,畸胎瘤2例,混合型生殖细胞瘤2例,淋巴瘤l例,脓肿2例,结核2例.精原细胞瘤仅1例AFP轻度升高,6例非精原生殖细胞瘤5例AFP升高.CT均存在有诊断价值的征像,尤其是多层螺旋CT多平面重建可显示病变的全貌及与周围结构的关系.结论 CT检查密切结合临床及肿瘤标记物检查,对于睾丸占位性病变的诊断和鉴别诊断有重要价值,多层螺旋CT多平面重建技术的应用对诊断有很大帮助.

CT diagnosis and pathological findings of testicular lesion

Objective To investigate the value of CT scan in the diagnosis and differential diagnosis of testicular space- occupying lesions. Methods In patients with testicular space-occupying lesions, 11 underwent examinations for such tumor markers as alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). Plain CT scans were performed with a section thickness and interval of 2 mm followed by enhanced scans after intravenous bolus injection of 70 ml 60% ultravist. Spiral CT multiplanar reconstruction images were also obtained. Results Of the 13 patients, histopathologically confirmed seminoma was found in 3, endodermal sinus tumor in 1, teratoma in 2, mixed germinoma in 2, leucoma in 1 case, abscess in 2, and tuberculosis in 2. One seminoma patient had slightly elevated AFP level while 5 of the 6 noneminoma patients (83%) had elevated AFP level. CT scans displayed characteristic features for diagnosis of testicular space-occupying lesions. Spiral CT with multiplanar reconstruction allowed full view of the lesions and demonstrated their relationship with the surrounding structures. Conclusion CT scan in combination with the clinical analysis and tumor marker examinations can be of important value in the diagnosis and differential diagnosis of testicular space-occupying lesions. The application of spiral CT multiplanar reconstruction also helps in the diagnosis.