胸腺上皮性肿瘤简化病理分型与CT表现的相关性  

Correlation of CT Findings and Simplified Histologic Types of Thymic Epithelial Tumours

作　　者：孙明霞[1] 虞崚崴[1] 蔡静[1] 徐蕾[1] 李惠民[1] 

机构地区：[1]上海交通大学医学院附属新华医院影像科

出　　处：《中国医学计算机成像杂志》2017年第1期41-45,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨胸腺上皮性肿瘤(TET)简化病理分型的CT表现特征及术前CT预测TET简化病理分型的价值。方法:回顾性分析经病理证实的68例TET的CT表现,按照WHO组织学分型后简化分为三组:低危组(A、AB、B1),高危组(B2、B3)和胸腺癌组;各组间比较采用卡方检验及单因素方差分析。结果:低危组11例,高危组42例,胸腺癌组15例。胸腺癌肿块更大,呈灌注式生长,更加边界不清、密度不均,并更多侵犯周围组织、纵隔淋巴结肿大或转移及胸膜转移(P<0.05)。重症肌无力更多见于胸腺瘤(P<0.05)。跨中线生长、边缘不规则或分叶状提示胸腺癌或高危胸腺瘤(P<0.05),胸痛症状更常见于胸腺癌组(P<0.05)。钙化、平扫CT值、胸腔积液在各组间未见统计学差异。结论:TET简化病理分型间的CT表现具有一定差异性,良好的术前CT增强检查可较好预测其分型,帮助临床制订治疗方案。Purpose： To assess the CT imaging findings of thymic epithelial tumors with different simplified pathological types. Methods： Sixty-eight patients with thymic epithelial tumor who underwent CT imaging were reviewed retrospectively. All cases were classified according to the WHO classification. Imaging characteristics of the three main subtypes were compared using the chi-square test and One-Way ANOVA. Results： There were 11 low-risk tbymomas, 42 high-risk thymomas, and 15 thymic carcinomas. Thymic carcinomas were larger and were more likely with blur margins, heterogeneous internal density, peripheral tissues invasion, elevated hemidiaphragm, mediastinal lymphadenectasis and pleural metastasis. Myasthenia gravis was less frequent in thymic carcinomas,while chest pain was more frequent. Thymic carcinomas and high-risk thymomas were more likely to spread on both sides of the midline and with irregular or lobulated contours.Calicification, nonenhanced CT value,hydrothrorax were not significatly different in three teams. Conclusion： The simplified histologic subtypes of thymic epithelial tumours have characteristic CT findings, which are valuable for distinguishing.

关 键 词：胸腺上皮肿瘤 体层摄影术 X线计算机 组织学分型 

分 类 号：R736.3[医药卫生—肿瘤] R730.44[医药卫生—临床医学]