摘要目的 探讨MRI在诊断睾丸肿瘤的病理类型及临床分期中的价值.方法 回顾性分析经病理证实的24例睾丸肿瘤患者资料.利用MRI对睾丸肿瘤的形态、信号、强化方式及周围组织侵犯情况进行评估,并与病理结果对比.结果 病理结果示24例患者的26个睾丸肿瘤,14个为恶性,包括4个弥漫性大B细胞淋巴瘤、7个精原细胞瘤、2个胚胎性癌及1个畸胎瘤.12个为良性,包括5个表皮样囊肿、2个单纯囊肿、2个炎性肉芽肿、2个纵隔管状扩张及1个假性纤维瘤.恶性肿瘤均为睾丸内肿瘤,6个局限于睾丸内,4个侵犯睾丸被膜或附睾,2个侵犯精索,2个侵犯阴囊壁.MRI术前诊断睾丸肿瘤病理类型的准确率为92.3％(24/26).MRI术前评价睾丸恶性肿瘤临床分期的准确率为85.7％(12/14).结论 MRI对于睾丸肿瘤病理类型的鉴别诊断及肿瘤分期具有较高准确性,对临床诊疗具有重要诊断价值.

abstractsObjective To assess the role of MRI in the preoperative characterization and local staging of testicular neoplasms.Methods A retrospective study of 24 patients suspected of testicular neoplasm was conducted.The histological diagnosis of testicular neoplasms was made and local extension of testicular malignancy was evaluated.The MRI findings were correlated with the pathologic results.Results Histological examination revealed 26 intratesticular lesions,14 of which were nalignant,including 4 cases of diffuse large B cell lymphoma,7 cases of seminoma,2 cases of embryonal carcinoma,one case of teratoma.Twelve lesions were benign,including 5 cases of epidermoid cyst,2 cases of simple cyst,2 cases of inflammatory granuloma,2 cases of testicular mediastinal tubular expansion and one case of testicular pseudo fibroma.Six malignant testicular tumors were confined within the testis,4 invaded the testicular tunicae or epididymis,2 invaded the spermatic cord,and 2 invaded the scrotal wall.The accuracy of MRI in the diagnosis of intratesticular lesions was 92％.The accuracy of MRI diagnosis in the local staging of testicular tunors was 86％.Conclusions MRI is highly accurate in the preoperative characterization and local staging of testicular neoplasms.It is of great significance to the clinical diagnosis and treatment.