中文摘要：

目的 探讨睾丸副睾肿块的CT和MRI影像学表现。方法 回顾性分析20例经手术病理证实的睾丸副睾肿块,其中3例行CT平扫及增强扫描,3例行CT直接增强,8例行MRI平扫及PWI动态增强,6例行MRI平扫,然后观察肿块的分布、形态大小、境界、内部结构、强化特点及周围侵犯转移情况及影像学显示方法,并与病理结果对比。结果病理结果示21个睾丸副睾肿块,睾丸肿块18例,副睾肿块2例,恶性肿块12例（精原细胞瘤5例,胚胎性癌3例,畸胎瘤1例,淋巴瘤1例,附睾横纹肌肉瘤1例,阴茎根部原始神经胚叶肿瘤1例）,良性肿块8例（畸胎瘤1例,睾丸间质细胞瘤2例,非异性炎性肿块1例,结核1例,表皮样囊肿2例,单纯囊肿1例）;恶性肿块4个局限睾丸,8个累及被膜及附睾,良性肿块1例累及附睾。影像学结果示恶性肿块直径平均大于50mm,肿块大多实性结节状,结节间纤维分隔,肿块强化不均匀,其中3例向周围侵犯及伴淋巴结转移;良性肿块直径平均小于20mm,肿块部分强化不均匀,较少伴淋巴结转移。MRI多序列及灌注检查,分辨肿块内、外组织成分,周围组织累及情况,鉴别肿块良、恶性方面优于CT检查。结论 睾丸副睾肿块CT、MRI表现有一定特征,CT、MRI检查有助于诊断及鉴别诊断,对提示其良、恶性有意义。

英文摘要：

Objective To investigate the CT and MRI manifestations of tumors in testicule and epididymis.MethodsWe retrospectively analyzed 20 patients with tumors in testicule and epididymis confirmed by surgery and pathology,of whom 3underwent plain CT scan and enhanced scan,3underwent CT enhancement directly,8underwent dynamic enhanced MRI scan and PWI,6underwent an MRI scan.And then,we observed the masses in terms of the distribution,size,shape,boundary,internal structure,strengthening characteristics and the surrounding invasion,metastasis,and imaging display method,and compared with pathological results.Results Pathological results showed 21 masses in testicule and epididymis,of which 18 were testicular tumor,2were tumors in epididymis,12 cases were malignant tumors（seminoma in 5cases,embryonal carcinoma in 3cases,teratoma in 1case,lymphoma in 1case,rhabdomyosarcoma in epididymis in 1case,the penis original nerve blast tumor 1case）,8cases were benign tumors（teratoma in 1case,testicular interstitial cell tumor in 2cases,non-inflammatory mass in 1case,tuberculosis in 1case,epidermal cyst in 2cases,simple cyst 1case）.Of 12 malignant tumors,four were limited to testicule,8involved in capsule and epididymis.As for the benign tumors,1case involved in the epididymis.Imaging results showed that the malignant tumors were greater than 50 mm in diameter on average,the masses were mostly solid nodular,with fiber separation between nodules,and the masses were uneven reinforcement,including 3cases of infringing upon the surrounding and accompanied with lymph node metastases.Benign masses were less than 20 mm in diameter on average,the masses were partial uneven reinforcement,with less lymph node metastases.MRI sequence and perfusion examination were superior to CT examination in distinguishing compositions inside and outside mass,involvement in the surrounding tissues,benign and malignant triats of masses.Conclusion The CT and MRI manifestations of tumors in testicule and epididymis have certain characteristics,which possess