Objectives      To evaluate the etiological diagnostic value of magnetic resonance imaging (MRI) in persistent and refractory hematospermia by analyzing pelvic MRI manifestations and characteristics.       Methods      The clinical data and morphological features of pelvic MRI images of bilateral seminal vesicles and ejaculatory duct area in 76 patients with persistent and refractory hematospermia were retrospectively analyzed.  

     Results      In the 76 patients undergoing MRI examination

47 patients showed the typical changes of signal intensity in seminal vesicle

including 23 patients with fresh hemorrhage showing high signal intensity on T1-weighted images (T

1

WI) and low signal intensity on T2-weighted images (T

2

WI)

and 24 patients with old hemorrhage showing middle to high signal intensity on both T

1

WI and T

2

WI. Twenty-six patients showed significant cystic dilatation of unilateral or bilateral seminal vesicles (the width was greater than 1.7 cm) with or without the internal signal intensity change

21 patients showed prostatic utricular cysts

3 patients showed ejaculatory duct cysts

3 patients showed Mullerian cysts

1 patient showed the seminal vesicle cyst

and 9 patients did not show any obvious abnormality in seminal vesicle area by comparing with the normal pelvic MRI images of 41 healthy adult men.       Conclusion      Three-dimensional MRI has a good resolution

and can clearly display the pelvic soft tissues and refined structures

such as seminal vesicle

prostate

vas deferens and ejaculatory duct. It has important etiological diagnostic value for patients with persistent and refractory hematospermia.