儿童睾丸肿瘤的MRI和B超诊断的对照分析
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摘要
目的回顾性分析儿童睾丸肿瘤的MRI与B超表现,探讨MRI在儿童睾丸肿瘤中的诊断价值。方法回顾性对照分析59例经手术和病理证实的儿童不同类型睾丸肿瘤的MRI和B超资料。结果 59例睾丸肿瘤样病变中,睾丸肿瘤54例,其中良性畸胎瘤17例(成熟性畸胎瘤15例,未成熟性畸胎瘤2例),卵黄囊瘤10例(其中混有成熟性畸胎瘤1例,伴有肺转移1例),良性囊肿23例(皮样囊肿5例,表皮囊肿14例,胚胎残留囊肿4例),睾丸性索间质细胞瘤2例,血管来源肿瘤(毛细血管瘤)1例,副脾1例。5例未手术者均为白血病双侧睾丸浸润(穿刺取病理证实)。其共同表现为睾丸不同程度增大,不同类型的睾丸肿瘤及肿瘤样病变有其各自的较为特征的MRI征象,MRI对病变检出、定性和肿瘤分型、分期均优于B超。结论 MRI对儿童睾丸肿瘤的检出、分型诊断和分期等具有重要价值。
Objective To investigate the diagnostic value of MRI and B-ultrasound diagnosis and the diagnostic value of MRI in children with testicular tumors, and to improve the imaging diagnostic ability of testicular tumors. Methods A retrospective analysis of 59 patients with different types of testicular tumors confirmed by surgery and pathology showed MRI and B-ultrasound data. Results Of the 59 testicular tumor-like lesions, 54 were testicular tumors, including 17 benign teratomas(15 mature teratomas, 2 immature teratomas), 10 yolk sac tumors, mixed with maturity. 1 case of teratoma, 1 case of pulmonary metastasis, 23 cases of benign cyst(5 cases of dermoid cyst, 14 cases of epidermal cyst, 4 cases of residual cyst of embryo), 2 cases of sex-cord stromal cell tumor, angiogenic tumor 1 case of capillary hemangioma and 1 case of accessory spleen. Five patients with unoperated patients were treated with bilateral testicular infiltration of leukemia in 5 cases(acupuncture confirmed by pathology). The common manifestation is that the testes are increased to varying degrees. Different types of testicular tumors and tumor-like lesions have their own characteristics of MRI. MRI is better than B-ultrasound in detecting, characterization, tumor classification and staging. Conclusion MRI is of great value in the detection, classification and staging of testicular tumors in children.
Objective To investigate the diagnostic value of MRI and B-ultrasound diagnosis and the diagnostic value of MRI in children with testicular tumors, and to improve the imaging diagnostic ability of testicular tumors. Methods A retrospective analysis of 59 patients with different types of testicular tumors confirmed by surgery and pathology showed MRI and B-ultrasound data. Results Of the 59 testicular tumor-like lesions, 54 were testicular tumors, including 17 benign teratomas(15 mature teratomas, 2 immature teratomas), 10 yolk sac tumors, mixed with maturity. 1 case of teratoma, 1 case of pulmonary metastasis, 23 cases of benign cyst(5 cases of dermoid cyst, 14 cases of epidermal cyst, 4 cases of residual cyst of embryo), 2 cases of sex-cord stromal cell tumor, angiogenic tumor 1 case of capillary hemangioma and 1 case of accessory spleen. Five patients with unoperated patients were treated with bilateral testicular infiltration of leukemia in 5 cases(acupuncture confirmed by pathology). The common manifestation is that the testes are increased to varying degrees. Different types of testicular tumors and tumor-like lesions have their own characteristics of MRI. MRI is better than B-ultrasound in detecting, characterization, tumor classification and staging. Conclusion MRI is of great value in the detection, classification and staging of testicular tumors in children.
引文
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8 龙德云,谭细凤,张艳,等.睾丸间质细胞瘤的CT/MRI表现及文献复习[J].中国临床医学影像杂志,2014,25:136-138.
9 Walther MM,Trulock TS,Finnerty DP,et al.Splenic gonadal fusion[J].Urology,1988,32:521-524.
10 蔡文超,罗敏,包强等.儿童阴囊内睾丸外肿物的CT和MRI表现[J].影像诊断与介入放射学,2017,26:287-291.
2 郑晓林,许达生.盆腔疾病CT、MRI鉴别诊断学[M].西安:中国出版集团世界图书出版,2013,392.
3 LeeSang Don.Epidemiological and clinical behavior of prepubertal testicular tumors in Korea[J].The Journal of Urology,2004,172:674-678.
4 Coret A,Leibovitch T,Heyman I,et a1.Ultrasonographicevaluation and clinical correlation of intratesticular lesions:a seriesof 39 cases[J].Br J Ur01,1995,76:216-220.
5 汤壮,魏强.睾丸肿瘤的影像学诊断及治疗[J].临床外科杂志,2015,2,23:98-100.
6 谭国强,马雁秀,李卓永,等。睾丸肿瘤的CT表现及其临床特征[J].医学影像学杂志,2013,23:569-576.
7 杜华芳,韩树高,陈英.睾丸原发肿瘤的MRI表现[J].浙江医学,2014,36:906-909.
8 龙德云,谭细凤,张艳,等.睾丸间质细胞瘤的CT/MRI表现及文献复习[J].中国临床医学影像杂志,2014,25:136-138.
9 Walther MM,Trulock TS,Finnerty DP,et al.Splenic gonadal fusion[J].Urology,1988,32:521-524.
10 蔡文超,罗敏,包强等.儿童阴囊内睾丸外肿物的CT和MRI表现[J].影像诊断与介入放射学,2017,26:287-291.