Yasuda Yuka, Osaka Akiyoshi, Izumi Keita, Iwahata Toshiyuki, Nakayama Akinori, Kubota Kazunori, Saito Kazutaka
Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
Department of Radiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
BMC Urol. 2025 May 28;25(1):140. doi: 10.1186/s12894-025-01825-4.
Only a few studies have performed histogram analysis for the differential diagnosis of testicular tumors. Therefore, the aim of this study was to evaluate the ability of magnetic resonance imaging, including diffusion-weighted imaging with apparent diffusion coefficient values, to differentiate between the histological types of testicular tumors.
Of the 156 testicular tumors diagnosed at our hospital between January 2010 and July 2023, 65 cases diagnosed with magnetic resonance imaging were included. Tumors were categorized as seminoma, non-seminoma, and malignant lymphoma. Apparent diffusion coefficient values were calculated and analyzed using the ratio to non-tumor testes and histograms according to tumor subtypes.
Among the 65 cases, 46, 14, and 5 entailed seminomas, non-seminomas, and malignant lymphomas, respectively. The apparent diffusion coefficient value ratio of seminomas (0.745 ± 0.132) was significantly higher than that of malignant lymphomas (0.531 ± 0.119, p = 0.013), and the apparent diffusion coefficient value ratios of non-seminomas (1.197 ± 0.430) were significantly higher than those of seminomas and malignant lymphomas (p = 0.0013 and p < 0.001, respectively). Seminomas and malignant lymphomas had significantly higher kurtosis values (8.55 ± 5.76 and 18.11 ± 5.22, respectively) than non-seminomas (4.92 ± 3.85, p = 0.012 and p = 0.0022, respectively). Malignant lymphomas had significantly higher kurtosis values than seminomas (p = 0.0123). Seminomas and malignant lymphomas had significantly higher skewness values (1.77 ± 1.00 and 3.12 ± 0.28, respectively) than non-seminomas (0.52 ± 1.17, p = 0.0016 and p < 0.001, respectively). Malignant lymphomas had higher skewness than seminomas (p < 0.001).
The present results demonstrate the efficacy of magnetic resonance imaging with apparent diffusion coefficient values and histograms in the differentiation of testicular tumor subtypes. A pre-operative diagnosis of testicular tumor subtypes may enable more effective management of testicular tumors, including pre-operative counseling and early treatment planning.
仅有少数研究对睾丸肿瘤的鉴别诊断进行了直方图分析。因此，本研究的目的是评估磁共振成像（包括具有表观扩散系数值的扩散加权成像）区分睾丸肿瘤组织学类型的能力。
在2010年1月至2023年7月期间我院诊断的156例睾丸肿瘤中，纳入了65例经磁共振成像诊断的病例。肿瘤分为精原细胞瘤、非精原细胞瘤和恶性淋巴瘤。根据肿瘤亚型，计算并分析表观扩散系数值与非肿瘤睾丸的比值以及直方图。
65例病例中，分别有46例、14例和5例为精原细胞瘤、非精原细胞瘤和恶性淋巴瘤。精原细胞瘤的表观扩散系数值比值（0.745±0.132）显著高于恶性淋巴瘤（0.531±0.119，p = 0.013），非精原细胞瘤的表观扩散系数值比值（1.197±0.430）显著高于精原细胞瘤和恶性淋巴瘤（分别为p = 0.0013和p < 0.001）。精原细胞瘤和恶性淋巴瘤的峰度值（分别为8.55±5.76和18.11±5.22）显著高于非精原细胞瘤（4.92±3.85，分别为p = 0.012和p = 0.0022）。恶性淋巴瘤的峰度值高于精原细胞瘤（p = 0.0123）。精原细胞瘤和恶性淋巴瘤的偏度值（分别为1.77±1.00和3.12±0.28）显著高于非精原细胞瘤（0.52±1.17，分别为p = 0.0016和p < 0.001）。恶性淋巴瘤的偏度高于精原细胞瘤（p < 0.001）。
目前的结果表明，具有表观扩散系数值和直方图的磁共振成像在鉴别睾丸肿瘤亚型方面具有有效性。术前对睾丸肿瘤亚型进行诊断可能有助于更有效地管理睾丸肿瘤，包括术前咨询和早期治疗规划。
