| Objective :To explore the clinical diagnostic value in testicular tumor by methods of Ultrasound、CT and MRIMaterials and Methods: The 35 cases of testicular cell tumors proved by pathological examinations were analyzed retrospectively. Analyse their clinical data, histopathology and imaging findings. In all testicular tumors, there were 15 cases of seminoma; three were 5 cases of the cryptorchid testis with seminoma; there were 7 cases of nonseminomatous germ cell tumor(NSGCT),including 2 cases of mixed germ cell tumor; there were 2 cases of teratoma,there were 3 cases of embryonal carcinoma; there were 4 cases of sex-cord-stromal tumors; there were 4 cases of lymphoma;there were 2 cases of metastatic tumor; there were 2 cases of adenmatoid tumor; there was 1 case of epidermoid cyst. There were 26 csses of testicular malignant tumor,9 cases of benign tumor. In the 15 cases of seminoma, 13 cases were examined by ultrasound, 9 cases were examined by CT and 6 cases were examined by MRI.In the 7cases of NSGCT, 7 cases were examined by ultrasound,3 cases were examined by CT and 4 cases were examined by MRI.In the 4 cases of sex cord-stromal tumor, 4 cases were examined by ultrasound, 2 cases were examined by CT and 1 case was examined by MRI. In the 4 cases of lymphoma, 3 cases were examined by ultrasound,1 case was examined by CT and 3 cases were examined by MRI. In the 2 cases of metastatic tumor, 2 cases were examined by ultrasound,2 cases were examined by MRI. In the group of adenmatoid tumor 2 cases were examined by ultrasound,1 case was examined by CT. The epidermoid cyst was examined by CT and MRI. In Ultrasound, the contents of tumor location, size, number, shape, internal echo, presence of sac change, the presence of calcification, richness of blood,blood flow velocity and vascular resistance index were observed. In CT, the contents of tumor location,size, number, shape, density, presence of cystic change, the presence of calcification, presence of adipose tissue, way of partial reinforcement in solid parts, CT value in scan, arterial,venous and delayed phase, whether blood supply artery enlargement, fiber interval reinforcement, edge reinforcement, Asymmetric strengthen spermatic cord blood vessels,inguinal lymph nodes, retroperitoneal lymph nodes were observed. In MRI,the contents of tumor location, size,number, shape, T1 WI signal, T2 WI signal, low T2 WI signal envelope, reinforcement in solid parts, presence of cystic change,presence of calcification, presence of adipose tissue, fiber interval reinforcement were observed.(1) According to specific pathological type, the cases were divided into 5 groups: group1:seminoma group, group2:nonseminomatous germ cell tumor group,group3:sex cord-stromal tumor group, group4:lymphoma group,group5:other benign tumors group(including adenomatoid tumor and epidermoid cyst).The number of the metastases was less, no longer grouping analysis.(2) According to the benign and malignant of pathology, the cases were divided into testicular malignant tumor and benign tumor group. Quantitative data results in average ± standard deviation, t test was used in the comparison of the two sets of data, analysis of variance was used in the multiple sets of data. the chi-square Fsher ’s accurate inspection was used in each sign compared. Has statistical significance difference(P < 0.05).Results:In sonographic findings, in the aspect of morphological rules,seminoma group has statistically significance difference with the NSGCT groups. In the aspects of sac change: seminoma group has statistically significance difference with the NSGCT group and sex cord-stromal tumor group. In terms of internal echo and richness of blood: seminoma group has statistically significance difference with the NSGCT groups.In CT findings, in the aspect of enlargement of blood supply arteries,seminoma group has statistically significance difference with other benign tumors group.In asymmetric spermatic cord reinforcement, seminoma group has statistically significance difference with lymphoma group and other benign tumors group. other benign tumors group has statistically significance difference with NSGCT group and sex cord-stromal tumor group. There were no statistically significant difference between the 5 groups in MR signs of testicular neoplasm.Benign testicular tumors has statistically significant difference with malignant tumors in the blood flow velocity, morphological rules, presence of cystic change, internal echo, richness of blood,mass density of internal,enlargement of blood supply arteries.Conclusion:1. Ultrasound is a good way to find and identify testicular mass with high accuracy.In ultrasound, the blood flow is rich and blood flow velocity is higher in seminoma than in nonseminomatous germ cell tumor, but it is difficult to identify histopathological subtypes.2. In CT, it makes a difference between seminoma and NSGCT in homogenous enhancement or not in solid compositions and the internal fiber interval reinforcement. Lymphoma has multiple CT signs which helps distinguishing the germ cell tumor. 3 Stage CT enhanced rate trends has little value in differential diagnosis of testicular tumors. Asymmetric spermatic cord blood vessels reinforcement is not found in all tumors.3.The MRI manifestation of testicular tumor is complex. Fiber interval reinforcement is characteristic of seminoma. The performance of lymphoma is similar to NSGCT in MRI. Low T2 WI signal ring generally appears in testicular tumor.4. Benign testicular tumors and malignant tumors have statistically significant difference in the blood flow velocity, morphological rules, presence of cystic change, internal echo, richness of blood,mass density of internal, enlargement of blood supply arteries. Testicular tumor signal is complex in MRI, it is lack of specificity of the a clear identification signs.5. Ultrasound, CT and MRI have their own advantages in the diagnosis of testicular tumor and each has relatively specific signs, it can play maximum potential in the diagnosis if three inspection methods were organic combined.6. The manifestations of different kinds of testicular tumors in ultrasound, CT and MRI still have a lot of overlap,it is necessary to combine with clinical data for further differential diagnosis. |
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