目的：探讨睾丸表皮样囊肿（TEC）的CT、MRI表现，提高该疾病认识。方法：回顾性分析16例经我院外科手术病理证实的TEC术前CT和MRI资料。11例接受睾丸MRI平扫，其中1例同时接受睾丸MRI增强检查。5例接受CT检查，其中4例同时接受睾丸增强CT检查。总结TEC的CT、MRI影像表现。结果：肿瘤均为单发肿瘤，位于左侧睾丸者9例，位于右侧睾丸者7例。15个病灶呈类圆形或类椭圆形，1个病灶形态不整。所有病灶边界清晰。病灶平均最大径为（2.28±1.72） cm。11例接受MRI检查中，T1WI上6个病灶呈不均匀的稍低信号或稍高信号，5个病灶呈均匀稍低或低信号，其中2个病灶中心局限性高信号，呈“靶征”；T2WI上10个病灶呈不均匀的稍高或高信号，1个病灶呈均匀的高信号，11个病灶均见T2WI低信号环影。5例行CT检查中，2例呈均匀稍低密度，2例呈均匀低密度，1例整个病灶呈结节样钙化密度改变。3例合并钙化，其中1例病灶壁见环形钙化，1例病灶较大，内见多发条片状及点状钙化。5例增强检查（1例增强MRI，4例增强CT）病灶中心未见强化，病灶壁见轻度强化。结论：TEC表现为单侧睾丸的类圆形或椭圆形囊性病灶，CT上表现为低或稍低密度病灶，可合并钙化灶；MRI T1WI表现为均匀或不均匀稍低或低信号，T2WI表现为稍高或高信号，几乎所有病灶均见低信号纤维环，结合典型影像表现有助于明确诊断。
Abstract
Objective: To investigate CT and MRI features of testicular epidermoid cyst(TEC) and increase understanding of the disease. Methods: Preoperative CT and MRI data of 16 pathologically proved TEC were analyzed retrospectively. Eleven cases underwent MRI scan and one of them also underwent enhanced MRI. Five cases underwent CT examination and four of them also underwent enhanced CT scan as well. Summarize the CT and MRI features of TEC. Results: According to the images, all cases showed single lesion, in which 9 were located in the left testicle and 7 in the right. Fifteen lesions were round or oval and 1 lesion was irregular. All lesions were well-marginated, with an average maximum diameter of (2.28±1.72) cm. Among the 11 cases underwent MRI, 6 showed unevenly slightly low or high signal, 5 lesions showed evenly slightly low or low signal and 2 showed regionally high signal in the lesion center, called “target sign”, on T1WI. Ten showed unevenly slightly high or high signal, 1 showed unevenly high signal and 11 showed low signal ring on T2WI. Among the 5 cases undergoing CT, 2 showed evenly slightly low density, 2 showed evenly low density and 1 showed nodular calcification. In the 3 cases with calcification, 1 showed annular calcified in the wall and 1 showed a large lesion with striped and punctate calcification. The 5 cases undergoing enhanced examination(both MRI and CT) showed slight enhancement in the wall without enhancement in the center. Conclusion: TEC is characterized by unilateral round or oval cystic lesion in testicle, which shows low or slightly low density with calcification on CT, evenly or unevenly low or slightly low signal on T1WI and high or slightly high signal on T2WI with almost all the lesion showing low signal ring.
关键词
睾丸肿瘤 /
表皮囊肿 /
体层摄影术 /
X线计算机 /
磁共振成像
Key words
Testicular neoplasms /
Epidermal cyst /
Tomography, X-ray computed /
Magnetic resonance imaging
中图分类号：
Ｒ737.21
Ｒ814.42
Ｒ445.2
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参考文献
[1]Shah KH, Maxted WC, Chun B. Epidermoid cyst of the testis: a report of three cases and analysis of 141 cases from the world literature[J]. Cancer, 1981, 47(3): 577-582.
[2]刘贤奎，刘屹立，孔垂泽，等. 睾丸表皮样囊肿21例报告[J]. 中华男科学，2002，8（6）：457-458.
[3]Sloan JC, Beck SD, Bihrle R. Bilateral testicular epidermoid cysts managed by partial orchiectomy[J]. J Urol, 2002, 167(1): 255-256.
[4]Loberant N, Bhatt S, Messing E, et al. Bilateral testicular epidermoid cysts[J]. J Clin Imaging Sci, 2011, 1(1): 4.
[5]Correa AF, Gayed BA, Tublin ME, et al. Epidermal inclusion cyst presenting as a palpable scrotal mass[J]. Case Rep Urol, 2012, 2012(9): 498324.
[6]Fanning D, Mc Dermott T. An epidermoid cyst presenting as testicular torsion in a patient with tri-orchidism[J]. BMJ Case Rep, 2011, 15(7): 1-2.
[7]Rosai J. 阿克曼外科病理学[M]. 回允中，译. 9版. 北京：北京大学医学出版社，2006：1416.
[8]李永强，李汉忠，王惠君，等. 睾丸部分切除术在睾丸良性肿瘤中的应用（附8例临床病例报告及文献复习）[J]. 现代泌尿生殖肿瘤杂志，2009，1（5）：271-273.
[9]Sut M, Thwaini A, Devlin B, et al. Intratesticular epidermoid cyst: is radiological diagnosis enough?[J]. Cent European J Urol, 2011, 64(4): 258-259.
[10]侯毅，崔立刚，王金锐，等. 睾丸表皮样囊肿的声像图表现及与病理改变的关系[J]. 中华超声影像学杂志，2007，16（1）：62-64.
[11]Shenoy V, Triest WE, el-Bash O. Bilateral epidermoid cyst of the testis: report of a case with preservation of 1 testis[J]. J Urol, 1995, 153(6): 1933-1934.
[12]宋庆达，滕剑波，李吉昌，等. 睾丸表皮样囊肿的超声表现及分型[J]. 中华医学超声杂志：电子版，2011，8（3）：525-530
[13]Maizlin ZV, Belenky A, Baniel J, et al. Epidermoid cyst and teratoma of the testis: sonographic and histologic similarities[J]. J Ultrasound Med, 2005, 24(10): 1403-1409.
[14]白冰，陈伟. 阴囊表皮样囊肿超声表现1例[J]. 中国临床医学影像杂志，2014，25（2）：152.
[15]马焕，吕玲，张大福，等. 体部表皮样囊肿的CT和MRI表现[J]. 实用放射学杂志，2014，30（11）：1861-1864.
[16]Cho JH, Chang JC, Park BH, et al. Sonographic and MR imaging findings of testicular epidermoid cysts[J]. AJR, 2002, 178(3): 743-748.
