睾丸原发肿瘤的CT表现及鉴别诊断

目的:分析睾丸原发肿瘤的CT影像特征。方法:回顾性分析46例经病理证实的睾丸肿瘤CT影像资料，结合其他资料对病灶做综合评估。结果:所有肿瘤均为单侧发病。精原细胞瘤24例，其中16例可见不均匀轻度分隔样强化；内胚窦瘤10例，8例可见多发迂曲、增粗供血血管；畸胎瘤4例，可见斑点状、不规则钙化，2例可见脂肪；混合性生殖细胞肿瘤2例，增强扫描明显不均匀强化，可见迂曲、增粗血管影，未见钙化及脂肪；平滑肌瘤2例，边界清晰，密度均匀，增强扫描轻度均匀强化；弥漫大B细胞淋巴瘤3例，2例边界清晰，密度均匀，增强扫描中度强化，1例局部边界不清，增强不均匀强化；恶性间质细胞瘤1例，可见粗大钙化，实性成分中度强化，伴腹膜后淋巴结及双肺转移。结论:对于不同类型睾丸肿瘤CT有较好的鉴别能力，能为临床治疗方案提供较为准确的依据。 

CT Findings and Differential Diagnosis of Primary Testicular Tumors

Objective: To analyze the imaging features of primary testicular tumor. Methods: The CT imaging data of 46 cases of testicular tumor confirmed by pathology were retrospectively reviewed. Combined with the other data, the location, attenuation, size, shape, edge, and enhancement patterns of lesions were comprehensively analyzed. Result: All 46 cases of testicular tumor were unilateral. There were 24 cases of seminoma, among whom 16 cases showed uneven mild septal enhancement; 10 cases of endodermal sinus tumor, and 8 cases showed multiple tortuous and thickened blood vessels; 4 cases of teratoma, spot or irregular calcification; 2 cases of mixed germinoma, obvious heterogenous enhancement with no calcification or fat; 2 cases of leiomyoma with clear border, homogeneous density and nhomogeneous enhancement in enhanced scan; 3 cases of diffuse large B cell lymphoma, 2 cases showed clear boundary, uniform density and homogeneous enhancement, 1 case of patchy low density area, with unclear boundary, persistent enhancement, the low density area showed no enhancement; 1 case of malignant mesenchymal cell tumor with thick calcification and moderate enhancement of solid components, accompanied by retroperitoneal lymph node and lung metastasis. Conclusion: CT can distinguish the imaging features of different types of testicular tumors, and have high value in the diagnosis and differential diagnosis of testicular tumors. Thus CT can provide a more accurate basis for clinical treatment.