GIÁ TRỊ CỦA CÁC DẤU HIỆU KÍCH THƯỚC, XÂM LẤN MÀNG TINH HOÀN VÀ TÍN HIỆU TRÊN CHUỖI XUNG T2W TRONG CHẨN ĐOÁN PHÂN BIỆT KHỐI U TINH HOÀN LÀNH TÍNH VÀ ÁC TÍNH TRÊN CỘNG HƯỞNG TỪ

Abstract

Objective: This study aimed to evaluate the utility of magnetic resonance imaging (MRI) features, specifically size, tunica albuginea invasion, and signal intensity on T2-weighted sequences, in differentiating benign from malignant testicular tumors. Methods: This retrospective, cross-sectional study included 47 patients with histopathologically confirmed testicular tumors (7 benign, 40 malignant). All patients underwent preoperative MRI of the scrotum. Three MRI features were assessed: maximum tumor diameter (< 16 mm or ≥ 16 mm), tunica albuginea invasion (yes or no), and signal intensity on T2-weighted images (homogeneous or heterogeneous). The diagnostic performance of these features in predicting benign versus malignant testicular tumors was evaluated. Results: Univariate and multivariate analyses demonstrated that tumor size (p = 0.000) and tunica albuginea invasion (p = 0.005) were significantly associated with malignancy. Signal intensity on T2-weighted images was not an independent predictor of malignancy (p = 0.67). Combining tumor size and tunica albuginea invasion did not improve diagnostic accuracy compared to using extension into the tunica vaginalis alone, which yielded a sensitivity of 57.5%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 29.2%. Conclusion: Tumor size and tunica albuginea invasion were significant predictors of malignancy in testicular tumors. However, combining these two features did not improve diagnostic accuracy compared to using extension into the tunica vaginalis alone, which demonstrated high specificity and positive predictive value but limited sensitivity.