【摘要】 目的：探讨儿童睾丸卵黄囊瘤（YST）的MRI特征性表现，并与病理对照，分析相关性。方法：回顾性分析2015年6月-2025年6月于我院经病理证实的10例儿童睾丸卵黄囊瘤患儿的临床表现、MRI图像及病理资料。结果：MRI表现：10例肿瘤中，均为单发病灶，形态呈类圆形（8例）或分叶状（2例），肿瘤最大径20～50 mm，平均（32.20±11.67）mm，体积通常较大。边界：7例边界相对清晰；3例边界模糊提示侵袭性。信号特征：T1WI上基本呈等或稍低信号，合并出血或高蛋白内容物时可呈斑片状高信号（2例）；T2WI上典型表现多为不均匀高信号，内见多发大小不等囊变区（特征性表现，7例）；DWI上实性部分呈明显高信号，ADC值减低。强化方式：增强扫描显示9例肿瘤实性部分呈明显不均匀强化，囊变区及坏死区无强化，1例肿瘤无明显强化。病理学检查证实肿瘤由原始上皮细胞构成多种结构（网状、微囊、内胚窦样、实性片状等），特征性见Schiller-Duval小体。免疫组化显示AFP（甲胎蛋白）强阳性（8例）。将MRI特征与病理结果对照分析发现，MRI上显著的囊变区对应于病理上的微囊或大囊结构及疏松黏液样间质；T2WI高信号对应于丰富的细胞外液及囊性成分；DWI高信号及ADC值减低与肿瘤细胞密集、核质比高相关；明显强化反映肿瘤血供丰富；出血、坏死在MRI与病理上表现一致。结论：儿童睾丸卵黄囊瘤的MRI表现具有一定特征性，尤其是T2WI高信号背景下见更高信号区、DWI明显受限、明显强化等，结合AFP值升高，常可明确诊断。更多还原

【Abstract】 Objective: To explore the MRI characteristic manifestations of yolk sac tumor(YST) in children’s testis and compare them with pathology to analyze the correlation. Methods: A retrospective analysis was conducted on the clinical manifestations, MRI images and pathological data of 10 children with testicular YST confirmed by pathology in our hospital from June 2015 to June 2025. Results:MRI manifestations: All 10 tumors were solitary lesions, exhibiting a roundish(8 cases) or lobulated(2 cases)morphology. The maximum tumor diameter ranged from 20 to 50 mm, with a mean of(32.20±11.67) mm,indicating generally large tumor sizes. Boundaries: The boundaries of 7 cases were relatively clear. Three cases with blurred boundaries suggest invasiveness of the tumor. Signal characteristics: It appears mostly isointense or slightly hypintense on T1 WI. When combined with hemorrhage or high-protein contents,patchy high signal could be presented(2 cases). The typical manifestations on T2 WI were mostly uneven hyperintense, and multiple cystic lesion areas of different sizes were seen within(characteristic manifestations, 7 cases). The solid part on DWI shows significantly hyperintense, and the ADC value decreases. Enhanced scanning showed that the solid parts of 9 tumors exhibited obvious heterogeneous enhancement,while no enhancement was observed in the cystic and necrotic areas. 1 tumor showed no obvious enhancement. Pathological examination confirmed that the tumor was composed of primitive epithelial cells to form various structures(reticular, microcysts, endodermal sinusoid, solid sheet-like, etc.), and was characterized by Schiller Duval bodies. Immunohistochemistry showed strong positivity of AFP(alphafetoprotein) in 8 cases. Comparison of the MRI features with the pathological findings revealed that,the significant cystic lesion areas on MRI correspond to the microcystic or large cystic structures and loose mucoid interstitium observed in pathology. The hyperintense on T2 WI corresponds to abundant extracellular fluid and cystic components. The hyperintense on DWI and decreased ADC value are associated with dense tumor cells and a high nucleocytoplasmic ratio. Significant enhancement reflects abundant blood supply to the tumor. Hemorrhage and necrosis were consistent in MRI and pathology. Conclusion: The MRI manifestations of YST in children’s testis have certain characteristics, especially hyperintense areas under the background of hyperintense on T2 WI, significant limitation and obvious enhancement on DWI,etc. Combined with the increase of AFP value, a clear diagnosis can often be made.更多还原