Imaging Study Of Testicular Tumors And Tumor-like Lesions

Objective: To explore the imaging features and diagnostic characteristics of benign and malignant testicular tumors and their common histological types,and to evaluate the diagnostic value and diagnostic efficacy of CT,ultrasound and MRI for testicular tumors,in order to improve the level of non-invasive diagnosis of testicular tumorscombined with clinical data.Materials and methods: A retrospective analysis of 84 patients(85 lesions)with basic clinical and imaging data of testicular tumors and tumor-like lesions confirmed by surgical pathology was undertaken.Forty-seven of them were examined for tumor markers.There were 33 cases with CT only,9 with MRI only,28 with CT andultrasound,12 with MRI and ultrasound,1 with MRI and CT,and only 1 with ultrasound,CT and MRI.In addition,47 patients were examined for tumor markers.According to the pathological results,they were divided into benign and malignant groups,seminoma and non-spermatoma,and their morphology,density /signal,and enhanced performance were compared and observed in different imaging examination groups.At the same time,the ability of tumor markers to distinguish seminoma and non-seminoma was discussed.According to the number of samples,chi square or Fisher test was used for statistical analysis.The area under the curve(AUC),sensitivity,specificity,positive predictive value and negative predictive value were obtained by ROC curve analysis of the three imaging examinations.Results:In ultrasound examination,the shape of testicular lesions and the relationship between testicular lesions and surrounding tissues were statistically significant in distinguishing between benign and malignant testicular tumors(P= 0.001,0.018),while the shape of testicular lesions was statistically significant for distinguishing seminoma from non-spermatoma(P=0.038).In CT examination,the morphology,relationship with surrounding tissues,internal septum,calcification,enhancement of septum and ring enhancement of testicular lesions were statistically significant in distinguishing benign and malignant testicular tumors(P = 0.004,0.008,0.003,0.029,0.041,0.034),while the morphology,internal septum,calcification,enhancement of septum and uneven lamellar enhancement were statistically significant for distinguishing seminoma from non-seminoma(P=0.015,< 0.001,< 0.015,< 0.001,<0.001);On MRI examination,the incidence of internal separation,delayed enhancement,interval enhancement,and ring enhancement features of the testicular lesions was statistically significant between benign and malignant groups(P = 0.024,<0.001,0.037,0.003);internal interval,interval The incidence of enhanced characteristics was statistically significant between the spermatogonia and nonseminoma tumor groups(P = 0.003,0.001).There was a statistically significant difference in the incidence of AFP elevation between the seminoma and nonseminoma tumor groups(P = 0.001).The sensitivity,specificity,positive predictive value,and negative predictive value of ultrasound for benign and malignant testicular tumors were 81.3%,60.0%,86.7%,and 50%,respectively.The area under the ROC curve was 0.706(P = 0.02);The diagnostic sensitivity,specificity,positive predictive value,and negative predictive value of testicular benign and malignant lesions were 98.2%,42.9%,93.2%,and 75.0%,respectively.The area under the ROC curve was 0.705(P= 0.043);The diagnostic sensitivity,specificity,positive predictive value,and negative predictive value of malignant lesions were 94.4%,50.0%,85.0%,and 75.0%,respectively,and the area under the ROC curve was 0.722(P = 0.054).Conclusion: The peak age of testicular tumor onset is 20-31 years old.The imaging signs of ultrasound,CT or MRI can be applied to the diagnosis of benign and malignant lesions of the testis and the differential diagnosis of seminoma and nonseminoma.AFP has a reliable guiding role in distinguishing spermatogonium from non-seminoma.The three imaging examination methods are of higher value for the diagnosis of benign and malignant testicular tumors.MRI is slightly better than CT and ultrasound for the diagnosis of benign and malignant testicles.