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目的:探讨睾丸附睾病变的MRI表现及其诊断价值。方法:34例睾丸附睾病变患者均行核磁共振成像(MRI)检查,扫描序列包括常规T1WI及T2WI、T2WI+FS及T1WI+FS,扫描方位为横断面、矢状面及冠状面,层厚2～4mm,从不同扫描序列及扫描方位图像观察病变部位、大小、形态、信号及其与周围组织关系,并与手术病理结果对比。结果:附睾囊肿5例,附睾结核2例,附睾非特异性炎症肿块7例,纤维假瘤1例,精子性肉芽肿4例,胚胎性横纹肌肉瘤1例,精索囊肿3例,隐睾伴疝囊形成4例,睾丸扭转出血坏死4例,睾丸恶性肿瘤3例。MRI对睾丸附睾病变定位准确,大多数睾丸附睾病变的MRI表现有一定特征性。结论:MRI的多方位、多序列扫描技术有助于睾丸附睾病变的清晰显示,从而推测其组织来源,提高诊断正确率,对其早期诊断及治疗有较高的临床价值。
Objective: To investigate the MRI findings of testicular epididymal lesions and its diagnostic value. Methods: Thirty-four patients with testicular epididymal lesions were examined by magnetic resonance imaging (MRI). The scanning sequences included conventional T1WI, T2WI, T2WI + FS and T1WI + FS. The scanning orientation was transverse, sagittal and coronal, ~ 4mm. The lesion, size, shape, signal and its relationship with the surrounding tissue were observed from different scanning sequences and scanning orientation images, and compared with the surgical pathology results. Results: There were 5 cases of epididymal cyst, 2 cases of epididymal tuberculosis, 7 cases of nonspecific inflammatory mass of epididymis, 1 case of fibrous pseudotumor, 4 cases of sperm granuloma, 1 case of embryonic rhabdomyosarcoma, 3 cases of spermatic cord cyst, Cyst formation in 4 cases, testicular torsion hemorrhage and necrosis in 4 cases, 3 cases of testicular cancer. MRI accurate positioning of testicular epididymal lesions, most of the testicular epididymal MRI features have some characteristics. Conclusion: MRI multi-orientation and multi-sequence scanning technique can help to clearly show the lesions of the testicular epididymis, so as to infer the source of tissue and improve the accuracy of diagnosis. It has high clinical value for early diagnosis and treatment.