Andrology Computed Tomography (CT)

The tomographic scan (CT) of the male patient can diagnose the prostate, seminal vesicles, testicular dysplasia, testicular tumors, and testicular hydrocele. X-ray penetration of the body's attenuation characteristics as a parameter for diagnosing disease. Different tissue structures of human body, the attenuation parameters of normal and abnormal tissue structures are different. Basic Information Specialist Category: Male Examination Check Category: CT Applicable gender: whether the male is fasting: not fasting Tips: Avoid sex life 24 hours before the test. Patients who are allergic to contrast agents are not eligible for this test. Normal value Normal prostate angiography has a clear outline and is basically symmetrical. Normal genital angiography has no lymph nodes and uniform density. Clinical significance Abnormal results: CT in prostate disease: prostate disease prostate CT diagnosis depends on its size. Understanding of changes in morphology and density. The normal prostate has a clear outline and is basically symmetrical. Prostatic hyperplasia and carcinoma can be characterized by irregular enlargement, but the lobulated solitary nodules on the contours are beneficial for the diagnosis of tumors. Prostate CT values ​​are limited in value, normal prostate tissue. There is no significant difference in the CT value between prostate cancer and prostate cancer. The density of observation is only valuable in the aspects of cystic change, abscess or tumor necrosis after injecting contrast agent. CT found that calcification is more sensitive than other imaging studies. Prostate congenital abnormal large cysts of the prostate and Mullerrian tube cysts, located in the posterior part of the midline of the prostate, with clear circular cystic lesions, water density or high and water density, and some margins can be calcified. The Mullerrian tube cyst is connected to the urethra. The contrast agent can be seen in the capsule after delayed scanning or post-urinary scanning. This can be distinguished from large cysts of the prostate. Prostate abscess The prostate abscess manifests as a single or scattered low-density lesion in the prostate. The enhanced examination is marginal enhancement, while the fluid area is not enhanced. The abscess penetrates the prostate capsule and forms diffuse inflammatory infiltrates and fluid retention in the tissues surrounding the prostate. Prostatic hyperplasia of benign prostatic hyperplasia is more common in the bilateral or middle leaves, the edges are clear and the density is uniform. It is characterized by transverse diameter or anterior-posterior diameter widening, and the transverse diameter is larger than the normal value. The anterior-posterior diameter is greater than the normal value, and the middle-leaf hyperplasia is dominant. When the middle lobe hypertrophy is enlarged, the prostate tissue protrudes into the bladder, which appears to be a lesion in the bladder, but the bladder wall is uniform and complete. Because CT can not distinguish between the inner and outer gland structures of the prostate, it is very difficult to distinguish between benign prostatic hyperplasia, inflammatory prostate enlargement and early prostate cancer. More than 95% of prostate cancer prostate cancer is adenocarcinoma. Early cancer is located in the nodules of the capsule, and there is no specific expression in density. CT shows a certain limit. If it is mucinous adenocarcinoma, it can show low-density lesions, because its mucus-containing components are especially obvious when the examination is enhanced. Prostate cancer occurs in the peripheral part of the prostate. When the tumor grows beyond the envelope, the prostate has a nodular irregular edge or lobulated shape. The most invasive of prostate cancer is the seminal vesicle. On CT, the angle of the seminal vesicle is narrowed or completely disappeared, and the sides are obviously asymmetrical. CT has a high accuracy rate for determining lymph node metastasis of prostate cancer, which is 80% to 90%. Prostate sarcoma Prostatic sarcoma is a non-uniform cystic lesion, which is infiltrated due to rapid tumor growth and infiltration of adjacent tissues. Occlusion of larger masses in the prostate and rectal adipose tissue. It can be seen that the pelvic cavity, bladder and rectum are involved. Tumors are prone to necrosis leading to isolated low-density areas. Osteolytic metastasis of common pelvis. Young people who are extensively infiltrating tumors of the prostate and surrounding tissues should consider the possibility of sarcoma first. CT in the application of seminal vesicle disease: seminal vesicle disease CT can better display the seminal vesicle, but because of tumors, abscesses, congenital anomalies are rare, so imaging experience is limited. Therefore, the indications for seminal vesicle CT scan are mainly the staging of prostate cancer and bladder cancer. The seminal vesicle angle of the bladder is very important for tumor staging, and its size and contour have large individual differences, which should be observed on both sides. The CT value measurement of the seminal vesicle is meaningful in the identification of cystic and solid lesions, and it is particularly important to use enhanced CT. Seminal vesicle cysts can be seen on the seminal vesicles with cystic thick-walled lesions and water sample density. The walls can be smooth or irregular and calcification is often seen. The wall of the capsule can be strengthened after enhanced scanning. Sometimes accompanied by abnormal or absent kidney morphology. When the tumor of the seminal vesic tumor is small, it is characterized by irregular lobular shape of the seminal vesicle; larger tumor, soft tissue swelling in the seminal vesicle area, low density lesion in the necrotic area, and sometimes spotted small calcification. Tumors often invade the pelvic, bladder, rectum, and prostate. On the CT, the edge of the tumor surrounding the tumor is blurred and uneven, and the lymph nodes are enlarged. Benign tumor fibroids and leiomyomas are solid tumors with soft tissue density with clear margins and no signs of invasive growth. Cyst adenomas present with polycystic lesions. Large benign tumors cause more displacement of the bladder and rectum. A typical dermoid cyst is often calcified in the wall of the capsule. CT in the application of external genital diseases: external genital diseases Most genital tumors in clinical examination, palpation can be clear its size, shape, texture, and has been diagnosed. CT is mainly used for the staging of these organ malignancies, especially metastatic lymph nodes and distant metastasis. In the search for the location diagnosis of cryptorchidism, CT operation is simple and non-invasive, and is often preferred. Cryptorchidism CT is used for clinical location and testicular positioning. The cryptorchidism is often located in the descending stroke of the testis, that is, in the retroperitoneum, groin, upper scrotum, etc., showing an oval soft tissue density, with a diameter of 1 to 2 cm, and the edge is clear. The cryptorchidism stays in the groin and accounts for 70%. The groin is symmetrical and can distinguish spermatic cords, so most cryptorchidism can be accurately located. The cryptorchidism that stays in the abdominal cavity is affected by intestinal fistula, blood vessels, and lymph nodes, and about 40% is false negative. Therefore, CT is not found, nor can it suggest unilateral testicular or testicular disease. If the cryptorchidism is greater than 3 cm, malignant transformation should be considered. Testicular malignancy Tumor malignant tumors are mostly unilateral, showing testicular enlargement, clear margins, uneven density, often to low-density areas of liquefaction necrosis, enhanced enhancement of the substantial part of the scan to varying degrees. Often accompanied by pelvic and retroperitoneal lymph node metastasis. The hydrocele of testicular hydrocele is water-like density, the boundary is clear, the density is uniform, and it is closely connected with the testis, and the enhanced scan is not enhanced. Post-traumatic hematoma and hemorrhage should be distinguished from hydrocele. The CT findings of spermatic tumors were not characteristic, showing a round mass in the peritoneal sulcus with clear boundaries, uniform density, and low density areas in the center. Due to the specific location, it is not easy to distinguish from cryptorchidism tumors. Patients in need of examination prostate, seminal vesicles, testicular dysplasia, testicular tumor, testicular hydrocele. Precautions Contraindications before inspection: avoid sexual life 24 hours before the examination; Requirements for inspection: Actively cooperate with doctors. Inspection process The male calculator tomography (CT) uses X-rays to penetrate the body's attenuation characteristics as a parameter for diagnosing disease. Different tissue structures of human body, the attenuation parameters of normal and abnormal tissue structures are different. The detector is used to convert the different attenuation numbers to analog-to-digital conversion, into digital and stored, and then processed by computer to form an analog signal input screen to reproduce the shape of the original tissue structure. Not suitable for the crowd Inappropriate population: Patients who are allergic to contrast agents.