摘要
目的：分析各型胸腺上皮肿瘤的CT特征，并评价其对低危、高危胸腺瘤及胸腺癌鉴别诊断的价值。方法：回顾分析经手术及病理证实的62例低危、高危胸腺瘤及胸腺癌的CT表现，分析每组病灶的特点，比较每一特点在3组之间有无显著差异。结果：胸腺癌较胸腺瘤多发生于前纵隔左侧；且胸腺癌较两组胸腺瘤病灶多伴有边缘分叶、瘤内坏死、心包及大血管受侵、纵隔淋巴结及远处转移；高危胸腺瘤较其他两组多伴有胸膜转移；胸腺癌的钙化多为簇状，而胸腺瘤则为结节状，且病变边缘壳样钙化和瘤内纤维分割仅见于胸腺瘤；而患者性别、年龄及病变最长径在3组间比较均无统计学差异。结论：多层螺旋CT扫描对于胸腺癌、高危胸腺瘤、低危胸腺瘤3组间的鉴别诊断具有重要价值。
Abstract
Objective: To assess the CT imaging findings of each type of thymic epithelial tumors and to determine useful findings in differentiating the main subtypes of low-risk thymomas, high-risk thymomas, and thymic carcinomas. Methods: CT features of 62 low-risk thymoma, high-risk thymoma, and thymic carcinoma cases confirmed by operation and pathology were reviewed retrospectively. The imaging characteristics of each group were compared and the main different characteristics among the three groups were analyzed. Results: On CT imaging, lobulation and irregularity of contour, necrotic or cystic component within tumor, great vessel invasion, presence of mediastinal lymphadenopathy and extrathymic metastasis are more common in thymic carcinomas than thymomas. High-risk thymomas usually have pleural metastasis. Clusters calcification are usually seen in thymic carcinomas, nodosity and punctiform and eggshell calcification are more common in thymomas. Conclusion: The presence of irregular contour, necrotic or cystic formation, mediastinal lymphadenopathy and extrathymic metastasis, great vessel invasion are suggestive of thymic carcinomas. The fiber diremption in tumor and eggshell calcification only seen in thymomas. Pleural metastasis are suggestive of high-risk thymomas.
关键词
胸腺瘤 /
体层摄影术 /
螺旋计算机 /
诊断 /
鉴别
Key words
Thymoma /
Tomography /
spiral computed /
Diagnosis /
differential
张文玉;黄 勇;申洪明;李文武.
多层螺旋CT在低危、高危胸腺瘤及胸腺癌鉴别诊断中的应用[J]. 中国临床医学影像杂志. 2011, 22(9): 612-615
ZHANG Wen-yu;HUANG Yong;SHEN Hong-ming;LI Wen-wu.
Applications of CT in the differential diagnosis of low-risk thymomas, high-risk thymomas, and thymic carcinomas[J]. Journal of China Clinic Medical Imaging. 2011, 22(9): 612-615
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