重症肌无力患者胸腺病变的CT和病理对照研究

Thymus in myasthenia gravis:comprasion of CT and pathologic findings

目的 探讨胸部 CT对胸腺病变的诊断价值。方法 对 2 2例重症肌无力患者胸部 CT和胸腺病理检查结果进行对照研究。结果 胸部 CT对胸腺异常诊断的敏感性达 88.8% ,特异性为 81.8%。其中对正常胸腺、胸腺增生和胸腺瘤诊断的特异性分别为 6 6 .7%、5 0 .0 %和 91.7%。结论 胸部 CT是诊断胸腺病变的较好方法 ,其诊断的敏感性和特异性高低与胸腺病变的性质相关 ,对胸腺瘤的诊断价值最高 ,能为提示或除外胸腺瘤的诊断提供帮助 。

Objective To correlate cmputed tomographic (CT) apperance of the thymus with results from histologic examination of thymic tissue. Method Twenty two patients with myathenia gravis underwent CT of the thorax and thymectomy. Finds of CT and pathology were available in all patients. Results Six patients had normal CT findings,four had a diffuse enlarged thymus,and 12 had a focal mass. The results of histologic examination showed that four of six patients with normal CT findings had normal thymic tissue and 2 had lymphoid follicular hyperplasia. Three of four aptients with an enlarged thymus of CT had lymphoid hyperplasia and one had thymoma. Eleven of 12 patients with a focal mass at CT had thymoma,and one had lymphoid hyperplasia. The sensitivity rate of CT in diagnosis normal,lymphoid hyperplasia and thymoma were 66.5%,50.0% and 91.7%,respectively. Conclusion CT is a good method to diagnosis thymic pathology. The sensitivity is related to histologoic changes. CT has a high value in distinguishing thymoma from other changes and is of limited value in distinguishing follicular hyperplasia from a normal thymus or thymoma.