侵袭性胸腺瘤与非侵袭性胸腺瘤的螺旋CT诊断

The value of helical CT in diagnosing the invasive and non-invasive thymoma

目的:评价螺旋CT对胸腺瘤的诊断价值。方法:对32例经临床、手术、病理证实胸腺瘤的CT表现进行回顾性分析,其中22例进行增强扫描。结果:侵袭性胸腺瘤18例(其中B型15例,C型3例),其中15例形态不规则,16例边界不清晰,17例累及邻近纵隔结构,脂肪间隙消失,16例显示内部密度不均匀,实质部分呈明显不均匀强化,5例为灌铸型。非侵袭性胸腺瘤14例(其中A型2例,AB型12例),其中13例形态规则,11例肿块密度均匀,4例增强扫描实质部分呈轻度均匀强化。结论:螺旋CT对判断B型、C型胸腺瘤与A型、AB型胸腺瘤准确性较高,对指导临床治疗及判断预后有重要临床意义。

Objective： To investigate the CT features of thymoma and their value in diferentiating the invasive from non-invasive thymoma.Methods：The CT features in thirty-two cases with thymoma confirmed by surgery and pathology,22 cases of those studied with contrasted CT scanning,were reviewed retrospectively.Results：Invasive thymoma in 18 cases（including type B 15 cases,type C 3 cases） was diagnosed by pathology.Fifteen cases of those were irregular in shape while 16 had ill defined margins.Seventeen cases involved the surrounding mediastinal structures resulting in loss of the fat tissue gap.The densities inside the tumors were heterogeneous with various enhancement in the solid component in 16 cases whereas the remaining 5 cases were regarded as casting type.Non-invasive thymic lesion was diagnosed by pathology in the other 14 cases（including Type A 2 cases,Type AB 12 cases） demonstrating regular morphology in 13 cases,homogeneous density in 11 cases,and slight and homogeneous enhancement in the solid component in 4 cases.Conclusion：The accuracy of the spiral CT in differentiating the non-invasive（Type A and AB） from the invasive thymoma（Type B and C） is relatively high,it has important clinical significance for the treatment and prognosis assessment.