赵秉双

[摘要] 目的 探讨彩色多普勒超声对睾丸恶性肿瘤的诊断价值，分析常见睾丸恶性肿瘤的影像特点。 方法 选取我院2016年1月～2017年6月就诊的睾丸恶性肿瘤患者80例为研究对象，分别采用彩色多普勒超声检查及核磁共振（MRI）检查睾丸恶性肿瘤的组织学类型、诊断符合率、肿瘤形态，对两组上述指标进行比较分析。 结果 两种方法对不同类型睾丸恶性肿瘤的检出率比较，差异均无统计学意义（P>0.05），核磁检测肿瘤直径（4.9±0.8）cm以及转移淋巴结直径（2.6±0.7）cm，均大于彩色多普勒超声检查，差异有统计学意义（P<0.05）。 结论 彩色多普勒超声检查经济、用时少，检出率高，可作为临床首选检查睾丸恶性肿瘤的手段，值得普及。

[关键词] 睾丸恶性肿瘤；淋巴结转移；精原细胞瘤；彩色多普勒超声检查

[中图分类号] R737.2 [文献标识码] B [文章编号] 1673-9701（2018）23-0118-04

Differential diagnosis of different types of testicular cancer by color Doppler ultrasound

ZHAO Bingshuang

Department of Ultrasound，Jilin Oilfield General Hospital，Songyuan 138000， China

[Abstract] Objective To investigate the diagnostic value of color Doppler ultrasonography in testicular malignant tumors and analyze the imaging features of common testicular malignant tumors. Methods 80 patients with testicular malignancy who were admitted in the hospital from January 2016 to June 2017 were selected as the study subjects. Color Doppler ultrasound and magnetic resonance imaging （MRI） were used to examine the histological types，diagnostic compliance rates，tumor morphologies of testicular malignant tumors. The above indicators between the two groups were analyzed and compared. Results There was no significant difference between the two methods in the detection rate of different types of testicular malignant tumors （P>0.05）. The tumor diameter（4.9±0.8）cm and the metastatic lymph node diameter（2.6±0.7）cm detected by magnetic resonance imaging were larger than those of the color Doppler ultrasound， and the difference was statistically significant （P<0.05）. Conclusion Color Doppler ultrasound is economical， less time-consuming， and has a high detection rate， which can be used as the first choice for clinical examination of testicular malignant tumors and is worth popularizing.

[Key words] Testicular cancer； Lymph node metastasis； Seminomas； Color Doppler ultrasound

睪丸肿瘤（testicular neoplasms）在临床上比较少见，仅占全身恶性肿瘤的1%，几乎均属于恶性，以20～40岁青壮年多见，且多为常见的实体肿瘤[1]。睾丸肿瘤的确切病因不清楚，但隐睾与之有关，其发生睾丸肿瘤的几率是正常睾丸的20～40倍，即使将睾丸复位也不能完全防止发生恶变，但有助于肿瘤早期的发现，其他引起睾丸肿瘤的因素可能与种族、遗传、化学致癌物质、损伤、感染、内分泌等有关[2]。而获得性因素包括睾丸损伤、职业和环境、营养不良和局部温度升高等。基因学的研究表明睾丸肿瘤与12号染色体短臂异位有关，p53基因的改变与睾丸肿瘤的发生具有相关性[3]。其治疗与长期的生化心血管危险因素有关：放疗后伴随着慢性炎症和内皮功能障碍的血清标志物升高，而化疗则伴随动脉粥样硬化的脂质变化的发展[4]。临……