摘要
目的:探讨顽固性血精症患者盆腔的核磁共振成像(MRI)影像学特点及其临床意义。方法:回顾性分析顽固性血精患者9例,先行盆腔MRI检查之后,8例48h内再行椎管麻醉下经尿道应用超脉冲等离子切割镜对精阜进行去顶状切开,输尿管镜下对精囊、前列腺内进行观察并与之相对应的影像学特点进行对比分析;1例行前列腺穿刺活检。结果:7例病灶位于精囊(双侧或单侧),大部分精囊腺体积增大,MRI表现为T1WI呈高信号或低信号,T2WI呈低信号或压脂序列呈高信号影;1例病灶位于前列腺中线区,MRI表现为在T1WI序列上见类圆形高信号影,边界清楚,直径约1.8cm,在T2WI及脂肪抑制序列上呈高低混杂信号影,可见分层;1例MRI表现为前列腺体积增高,大小约4.5cm×3.4cm×5.1cm,左后方外周带可见了类圆形灶,呈等T1短T2信号,直径约1.7cm,边界模糊,增强后病灶呈较均匀强化。8例患者进行输尿管镜下观察,发现7例患者在相应精囊(双侧或单侧)存在咖啡色或暗红色胶冻状液体,精囊有不同程度炎性改变。1例前列腺区见囊状肿块内见暗红色液体;1例血精患者盆腔MRI平扫提示前列腺癌,穿刺活检术后证实为前列腺癌。结论:MRI检查能清晰显示精囊、前列腺的病变,对于顽固性血精症患者的诊断及治疗具有重要参考价值。
Objectives： To explore the features and clinical significance of pelvic MRI imaging in the treatment of persistent hemospermia. Methods： A retrospective analysis was made of nine patients with intractable hematospermia. Firstly, pelvic MRI examination was conducted on the nine patients. Then eight patients received intrathecal anesthesia within 48 hours, and then pulsed plasma cutting microscope was applied transurethrally to cut apart the top of vemmontanum. Seminal vesicle and prostate were observed under ureteroscope and compared with their corresponding MRI imaging features for further contrastive analysis. One of the nine patients received needle biopsy of the prostate. Results： Seven of the nine patients showed their niduses in semi- hal vesicle （bilateral or unilateral）. Most of them increased their seminal vesicle volume, which was reflected by MR/features： TIWI showed high signal or low signal, T2WI showed low signal or its fat suppression sequences showed shadow of high signal; One patient had the nidus locating in the midline area of the prostate. MRI scan demonstrated quasi - circular shadow of high sig- nal on T1WI with the clear boundary and about 1.8 CM in diameter. The shadow of high - low mixed signal with visible layer was presented on rF2WI and fat suppression sequences; One patient indicated increased prostate volume in MRI imaging with the ap- proximate size of 4.3 ＊ 3.4 ＊ 5.1 （ CM3 ）. On the left rear part of prostate ~ peripheral zone, a quasi - circular nidus could be seen and its signals were isointensity T1 and short T2. Its diameter is about 1.7cm and the boundary is fuzzy. Nidus can be al- most uniformly enhanced after being strengthened ; Eight patients were observed under ureteroscope, and seven of them were found to have coffee or dark red gelatin -like liquid in the corresponding seminal vesicle （bilateral or unilateral）. What is more, their seminal vesicles demonstrated different levels of inflammatory change ; One patient has dark red liquid in the cystic
出处
《中国性科学》
2012年第6期18-21,17,共5页
Chinese Journal of Human Sexuality
关键词
血精
MRI
X线计算机
Hematospermia
Magnetic resonance imaging
X - ray computer
