胸腺上皮肿瘤MSCT影像与WHO组织学分型的对照分析

Thymic epithelial tumors:comparison of MSCT findings and WHO histological classification

目的分析胸腺上皮肿瘤多层螺旋CT(MSCT)影像特征,并与WHO组织学分型对照。方法回顾性分析34例经手术及病理证实的胸腺上皮肿瘤患者术前MSCT表现,并将其与WHO组织学分型及其简化分型[低危胸腺瘤(A、AB、B1型)、高危胸腺瘤(B2、B3型)和胸腺癌(C型)]进行对比。结果胸腺癌的长、短径均大于低、高危胸腺瘤(P均<0.05);边缘不规则或分叶状、非局限、对邻近结构的侵犯在高危胸腺瘤和胸腺癌中均较在低危胸腺瘤中更常见(P均<0.05)。结论MSCT能够反映胸腺上皮肿瘤的生物学特性,具有预测其组织学类型和判断预后的潜力。

Objective To analyze the MSCT findings of thymic epithelial tumors （TET） correlated with WHO histological classification, and to identify the value of MSCT in diagnosos of TET. Methods The pre-operation MSCT findings of 34 patients with TET proved by surgery and pathology were reviewed retrospectively and compared with WHO histological classification, and the patients were simplifiedly subgrouped based on the WHO classification scheme：low-risk thymomas （types A, AB, B1）, high-risk thymomas （types B2, B3）, and thymic carcinomas （type C）. Results The length of the thymic carcinoma in long-and short-axis diameters were significantly longer than that of high-risk thymomas and low-risk thymomas （P〈0. 05）. Tumors with irregular or lobulated contour, erosion of surrounding fat plane and adjacent structures invasion were significantly more frequent in high-risk thymomas and thymic carcinomas than that in low-risk thymomas （P〈0. 05）. Conclusion MSCT findings can reflect the biologic behavior of the thymic epithelial tumors, and would have potentials for predicting the WHO histological classification and the prognosis of the thymic epithelial tumors.