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湘雅二医院课件荟萃
蔡晔雨
FIGURE 34.34. 输精管钙化。CT平扫显示双侧输精管（箭头）的钙化。这一发现几乎普遍与糖尿病相关。
巴克筋膜包住阴茎体和深部血管，并与深部泌尿生殖筋膜近端融合（55）。松散的外达式筋膜层与会阴部的克勒斯式筋膜相连续。巴克筋膜内血肿或积液仍保留在阴茎上，而巴克筋膜外部的血肿或积液可延伸至阴囊或前腹壁。血液供应延伸为阴部内动脉的分支，其由髂内动脉发出。阴茎背动脉和静脉供应龟头、阴茎皮肤以及远端海绵体。延髓动脉供应尿道和近端海绵体。
病理. 阴茎骨折罕见并且最初由美国评估最佳，这证明了白膜的缺陷和相关血肿，通常局限在巴克筋膜内。在MR上，白膜是低信号并且在T1WI和T2WI上均得到充分证实。T1WI可以检测T2WI上由高信号血肿模糊的细微骨折。需要紧急的诊断和手术治疗，因为延迟可能导致勃起障碍和畸形。痛性阴茎硬结，局灶性或广泛性阴茎异常勃起，最常由佩罗尼病引起，这是一种结缔组织疾病，在白膜中产生斑块，导致阴茎弯曲和畸形（54）。佩罗尼病可能伴有急性疼痛或慢性畸形。超声和MR显示局灶性纤维斑块导致白膜增厚。在MR上，斑块与T1WI和T2WI上的白膜一致是低信号。在急性期，增强扫描可能明显。钙化可能发生在慢性期的斑块中。阴茎肿瘤通常通过临床检查准确分期。MR对于成像分期和显示淋巴结增大和肿瘤复发最准确（56）。大多数肿瘤是鳞癌或罕见的肉瘤。这些癌症在T1WI和T2WI两者中都显示为低信号不规则浸润性肿块。静脉注射对比剂增强扫描后，肿瘤比体部强化更明显。
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