胸腺上皮肿瘤CT征象与WHO简化病理分型的相关性  

Relationship between CT features and WHO simplified pathological classification of thymic epithelial tumors

作　　者：金晶[1] 邹立巍[1] 赵红[1] 郑穗生[1,2] JIN Jing;ZOU Liwei;ZHAO Hong;ZHENG Suisheng(Department of Radiology,the Second Affiliated Hospital of Anhui Medical University Hefei 230000,China;Imaging Center,Anhui Medical University,Hefei 230000,China])

机构地区：[1]安徽医科大学第二附属医院放射科,安徽合肥230000 [2]安徽医科大学医学影像研究中心,安徽合肥230000

出　　处：《实用放射学杂志》2018年第9期1343-1347,共5页Journal of Practical Radiology

基　　金：安徽省教学质量工程项目（2014jxtd119）。

摘　　要：目的 探讨胸腺上皮肿瘤（TET）的CT表现特征与WHO简化病理分型的相关性。方法 回顾性分析经手术病理证实的67例TET患者的胸部CT影像学资料，所有患者均做胸部CT平扫及增强扫描，按照WHO组织学分型后简化分为3组：低危组（A、AB、B1），高危组（B2、B3）和胸腺癌组;定性资料采用χ2检验，定量资料采用单因素方差分析。结果 低危组36例，高危组21例，胸腺癌组10例。低危组胸腺瘤较常见低密度线状分隔，且低危组强化幅度［（33.44±10.60） HU］比高危组［（23.62±6.73） HU］及胸腺癌组［（24.00±3.56） HU］更高，无胸膜及心包侵犯。高危组及胸腺癌组更常表现为边缘不规则或分叶、胸膜及心包侵犯、胸腔积液。而周围脂肪絮状影及纵隔血管侵犯在本研究病例中只见于胸腺癌组（P〈0.05），且胸腺癌组可见更大长径［（10.24±1.66） cm］，并与低危组［（6.55±3.05） cm］及高危组［（6.68±2.55） cm］间有明显统计学差异（P〈0.05），低危组与高危组组间长径无差异性（P〉0.05）。钙化则更多见于高危组（P〈0.05）。结论 TET的WHO简化病理分型中，低危胸腺瘤、高危胸腺瘤及胸腺癌3组间的CT表现有明显差异。低密度线状分隔、强化幅度明显对低危组胸腺瘤具有较高诊断价值；周围脂肪絮状影、纵隔血管侵犯及更大长径高度提示胸腺癌；胸膜及心包侵犯征象可出现在高危组及胸腺癌组。Objective To discuss the relationship between CT features and WHO simplified pathological classification of thymic epithelial tumor （TET}.Methods Plain and enhanced CT findings of 67 patients with TET confirmed by surgery and pathology were analyzed retrospectively. According to the WHO simplified pathological classification, cases were divided into low-risk thymomas group （ A, AB, B1 ）, high-risk thymomas group （ B2, B3 ） and thymic carcinomas group.The chi-square test was used to analyze qualitative data,and quantitative data was analyzed by One-Way ANOVA.Results There were low-risk thymomas group （36 cases） ,high-risk thymomas group （21 cases） and thymic carcinomas group （10 cases）.The enhancement degree of low-risk thymomas [（33.44±10.60） HU] was more obvious than high-risk thymomas [ （23.62± 6.73） HU] and thymic carcinomas [ （ 24.00 ± 3.56） HU],and without pleural or pericardiac invasion.Low density linear separation was more common in low-risk thymomas. Irregular margin/lobulation,invasion of pleural and pericardiac, pleural effusion were more common in high-risk thymomas and thymic carcinomas.The flocculent changes in perivascular adipose tissue and mediastinal vascular invasion were only found in thymic carcinomas.The length of thymic carcinomas [（10.24±1.66） cm] was longer than low-risk thymomas [（6.55±3.05） cm] and high-risk thymomas [（6.68±2.55） cm]（P〈0.05}, there was no significantly difference between low-risk thymomas and high-risk thymomas （P〉0.05）. Calcification was more common in high-risk thymomas （P〈0.05）.Conclusion There are significant differences on CT characteristics between the three groups （low-risk thymomas, high-risk thymomas and thymic carcinomas） according to the WHO simplified pathological classifications of TET. Low density linear separation and obvious enhancement degree are of high diagnostic value in low-risk thymomas. The flocculent changes in perivascular adipose tissue, mediastinal vascular invasion and lo

关 键 词：胸腺上皮肿瘤 计算机体层成像 组织学分型 病理学 

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