MSCT对低危型、高危型胸腺瘤及胸腺癌的鉴别诊断价值  

The value of MSCT in the differential diagnosis among low-risk thymomas,high-risk thymomas,and thymic carcinomas

作　　者：陆杨 赵亚娥 杨春燕[2] 尤小芳[3] 

机构地区：[1]杨浦区市东医院影像科,上海200438 [2]石河子市人民医院影像中心,新疆832000 [3]同济大学附属上海市肺科医院影像科,上海200433

出　　处：《放射学实践》2017年第2期149-152,共4页Radiologic Practice

摘　　要：目的:探讨MSCT对低危型、高危型胸腺瘤及胸腺癌的鉴别诊断价值。方法:将68例经穿刺或手术病理证实的胸腺上皮性肿瘤(TETs),按WHO简化病理分型分为低危型胸腺瘤、高危型胸腺瘤和胸腺癌三组,对三组的MSCT征象进行统计学分析。结果:68例TETs中,低危型胸腺瘤31例(A型4例、AB型19例、B1型8例)、高危型胸腺瘤15例(B2型9例、B3型6例)、胸腺癌22例。高危型胸腺瘤、胸腺癌均较低危型胸腺瘤更易表现为肿瘤边缘不规则或分叶(P均<0.05);高危型胸腺瘤、胸腺癌均较低危型胸腺瘤更易出现对胸膜/心包、邻近大血管侵犯(P均<0.05);增强后密度不均及囊变坏死率在胸腺癌和低危型胸腺瘤间均具有显著性差异(P均<0.001);胸腺癌出现纵隔淋巴结转移较低危型、高危型胸腺瘤更为常见(P<0.05);而瘤内钙化在三者间两两比较均无明显统计学差异(P均>0.05)。结论:MSCT对WHO简化病理分型的TETs具有一定的鉴别诊断价值。Objective：To explore the value of MSCT findings of thymic epithelial tumors（TETs）in differentiating the WHO simplified pathological subtypes.Methods：The CT imaging of 68 patients with TETs confirmed by pathology（needle biopsy/surgery）were reviewed retrospectively,all cases were classified into 3groups as low-risk thymomas,highrisk thymomas and thymic carcinomas,and then statistical analysis was made.Results：Among 68 cases,there were 31 lowrisk thymomas（4type A,19 type AB,and 8type B1）,15high-risk thymomas（9type B2 and 6type B3）,and 22 thymic carcinomas.High-risk thymomas and thymic carcinomas were more likely to have lobulated or irregular contours（P〈0.05）,pleural or pericardial invasion（P〈0.05）,and great vessel invasion（P〈0.05）than low-risk thymomas.Thymic carcinomas were more likely to have necrotic or cystic component（P〈0.05）and heterogeneous contrast-enhancement（P〈0.05）than low-risk thymomas.Thymic carcinomas were more likely to have lymphadenopathy（P〈0.05）than low-risk thymomas and high-risk thymomas.There was no significant statistical difference in calcification inside the tumor among different groups（P〉0.05）.Conclusion：MSCT imaging findings are valuable for distinguishing WHO simplified pathological subtypes.

关 键 词：胸腺肿瘤 胸腺上皮肿瘤 体层摄影术 X线计算机 病理学 

分 类 号：R736.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]