Study Of MSCT Imaging Diagnosis And Differential Value For Benign And Malignant Testicular Tumor

Purpose: To evaluate the value of Multi-slice CT in the diagnosis and differentialdiagnosis and staging of primary testicular tumors.Materials and methods:48cases of testicular tumor confirmed by surgically andpathologically were collected for this study.Their clinical features, pathologicalclassification and MSCT appearances were retrospectively analyzed.Plain andcontrast enhanced MSCT scanning were performed in all48testicular tumors.PlainMSCT scaning were performed with a section thickness and interval of2mm. andcontrast enhanced MSCT scaning were performed with1mm thickness and interval.Reconstructions with the lowest practical slice thickness were done and postprocessing reconstructions (PPR) were acquired including Multi PlanarReconstruction (MPR), volume rendering (VR).48cases of testicular tumor including13seminomas,9malignantmixed germ cell tumors,14malignant lymphoma,2yolksac tumor,2mature cystic teratoma,2adenomatoid tumor,2epidermoid cyst,1embryonalcarcinoma,1embryonal carcinoma,1leiomyoma,1solitary extramedullaryplasmacytoma.Result: MSCT could correctly detect all of the48tumors,48cases were found inone side testicle,19cases in leftside,29cases in rightside.The MSCT plant scanfeatures of45cases are the testis enlarged,35cases are clear margin,41cases withmalignant testicular tumor average diameter of4.6±1.3cm,7cases with benigntesticular tumor average diameter of2.4±0.8cm, The significance level α set as0.05.There was statistically significant difference (t=4.351，P<0.05),but there was notsignificantly different(t=0.013, P＞0.05) between malignant and benign testiculartumor’s enhancement during multi-phase contrast enhanced CT scan.Among41casesmalignant testicular tumor, seminomas and malignantmixed germ cell tumor’s enhancement degree was not significantly different(t=-1.578, P＞0.05),malignantmixed germ cell tumor and lymphoma’s enhancement degree was notsignificantly different(t=0.528, P＞0.05)，but there was statistically significantdifference (t=-2.686，P<0.05) between seminomas and lymphoma’s enhancementdegree. The mean onset age of malignantmixed germ cell tumor and lymphoma wasstatistically significant difference (t=-8.196,P<0.05). Most of the YST cases werechildren younger than5years old, the features of laboratory tests had AFP on higherlevel. On plain MSCT scan, calcification and fat could be seen in2benign teratomas.adenomatoid tumor revealed well-distributed density in CT plain scan and withoutenrichment after enhancement. The different pathological types of testicular tumorshad their own characteristics of the images and clinical features. Among41casesmalignant testicular tumor, no swelling lymph nodes were found during MSCT scanin31patients, retroperitoneal or inguinal lymphadenopathy were found in3case,1patient with swelling supraclavicular lymph nodes, respectively prompt clinical phaseI, II and III,indicate compliance with pathological stage.Conclusion: Testicle tumors have a certain characteristic performances ofMSCT,and MSCT can find out the lymphoid node metastasis and distantmetastasis, isvery helpful in the diagnosing and clinical staging of testicular tumor. Combined withclinical reference, MSCT plays an important roll in differentiating the kinds oftesticular tumor,especially in the differentiation between benign and malignanttesticular tumors, tumor staging before therapy and surveillance after therapy.