摘要
目的探讨睾丸表皮样囊肿的不同声像图表现及与病理组织学关系，总结其特异性声像图特点。方法回顾性分析14例经手术病理证实的睾丸表皮样囊肿的超声图像特点、声像图类型及其与病理改变的关系，并与同期手术的47例其他睾丸占位性病变的声像图表现进行对比。结果14例睾丸表皮样囊肿患者16个病灶具有多种超声表现，可分为4类。①螺纹征型（6个病灶）：呈“洋葱皮样”强弱回声交替排列，与病理层状分布的致密角质层和坏死鳞状上皮细胞相一致。②周边回声增强／钙化型（4个病灶）：声像图表现肿物中央回声减低而周边呈环行回声增强，病理显示肿物中央为坏死鳞状上皮，周边为致密的纤维层并可伴钙化。③混合型（4个病灶）：肿物呈形态不规则的中低回声，其内有斑块状强回声伴或不伴声影，无明显包膜，病理表现为囊肿纤维包膜不完整，周边呈较厚的瘢痕，内部可见杂乱的钙化灶。④致密钙化型（2个病灶）：为边缘清晰的不规则密集强回声伴声影而无明显肿物结构，相应病理改变为大量钙化的角质层和骨样组织。以上四种超声表现与同期其他睾丸肿瘤声像图特点比较，其中螺纹征型、周边回声增强／钙化型仅见于表皮样囊肿，为其特异性超声表现。结论睾丸表皮样囊肿具有比较典型的超声表现，并且声像图类型与不同病理组织学改变相对应。其中，螺纹征及周边回声增强／钙化型表现是表皮样囊肿的特征性声像图类型。
Objective To investigate various sonographic appearances of testicular epidermoid cysts（TEC） and their correlation with pathological findings. Methods Sonographic and histologic features of 14 TEC confirmed by pathologic findings were studied retrospectively. Sonographic appearances of TEC were compared with other testicular masses. Results There were 4 different sonographic patterns of TEC：①Whorled or onion ring appearance with altering rings of hyperechogenicity and hypoechogenicity which corresponded to the alternating layers of compacted keratin and desquamated squamous cells seen histologically; ②A solid mass with an echogenic or calcified rim corresponded to a calcified or non-calcified fibrous wall with central desquamated squamous cells; ③An unwell-defined heterogeneous mass with central cluster of calcifications represented surrounding thickened scar tissue and central cluster of calcifications; ④Dense calcification formation with no discernable cyst due to acoustic shadowing corresponded histologically to bone formation and extensive calcification. Whorled appearance and an echogenic rim were only found with TEC. Conclusions TEC had various sonographic appearances which corresponded to different histologic changes, and whorled pattern and an echogenic rim were the typical sonographic findings.
出处
《中华超声影像学杂志》
CSCD
2007年第1期62-64,共3页
Chinese Journal of Ultrasonography
关键词
超声检查
睾丸疾病
表皮囊肿
Ultrasonography
Testicular diseases
Epidermal cyst
