顽固性血精患者MRI 影像特征研究.docVIP

顽固性血精患者MRI影像特征研究 李波军，李 珂，张 超，张 军，张 勇，周 波，孙中义，靳风烁，张克勤，李彦锋 (400042 重庆，第三军医大学大坪医院野战外科研究所泌尿外科) [摘要] 目的 分析顽固性血精患者的盆腔核磁共振成像（magnetic resonance imaging，MRI）表现及其影像学特征性改变，探讨MRI在顽固性血精病因诊断中的价值。方法 回顾性分析76例顽固性血精患者的临床资料，对其盆腔MRI图像进行形态学特征观察，重点分析总结双侧精囊及射精管区域的影像学特征。结果 与正常男性精道远端区域的MRI特征性影像相比较，76例顽固性血精患者的影像学特征改变主要有：47例表现为精囊区域的特征性信号强度改变，其中23例存在鲜红色血精的患者在T1加权相（T1-weighted images T1WI）精囊呈明显高信号影，在T2加权相（T2-weighted images T2WI）呈明显低信号影，而24例存在咖啡色或巧克力样陈旧性血精的患者在T1WI相和T2WI相均呈中至高等强度信号影；26例显示一侧或双侧精囊呈明显囊性扩张（横径大于1.7cm），伴或不伴上述精囊内信号强度的特征性改变；21例存在前列腺小囊囊肿；3例存在射精管囊肿；3例存在苗勒氏管囊肿，1例存在精囊囊肿；9例患者精囊区域无明显异常改变。结论 MRI可有效显示顽固性血精患者精囊、前列腺、射精管区域的精细结构改变，对顽固性血精的病因学诊断及治疗方式的选择具有重要的指导价值。 ［关键词］ 血精；磁共振成像；特征；病因；诊断 [中图法分类号] [文献标志码] A Study on the characterization of magnetic resonance imaging in refractory hematospermia Li Bojun, Li Ke, Zhang Chao, Zhang Jun,Zhang Yong,Zhou Bo,Sun Zhongyi,Jin Fengsuo,Zhang Keqin,Li Yanfeng(Department of Urology , Daping Hospital , Institute of Surgery Research ,Third Military Medical University , Chongqing 400042 , China) [Abstract] Objectives To evaluate the etiological diagnostic value of magnetic resonance imaging (MRI) in persistent and refractory hematospermia by analyzing their pelvic MRI manifestations and characteristic changes. Methods The clinical data, bilateral seminal vesicles and ejaculatory duct area morphological features of pelvic MRI images of 76 cases of persistent and refractory hematospermia patients were retrospectively analyzed. Results Out of the 76 patients underwent MRI examination, 47cases showed the typical change of the signal intensity in seminal vesicle，cases with fresh hemorrhage showed high signal intensity on T1-weighted images ( T1WI )，and low signal intensity on T2-weighted images (T2WI ), while the cases with old hemorrhage showed middle to high signal intensity on both T1WI and T2WI; 26 cases showed significant cystic dilatation of unilateral or bilateral seminal vesicles (the width is bigger