侵袭性胸腺瘤CT表现与诊断价值

CT findings of invasive thymoma and the diagnostic value of CT

目的 探讨侵袭性胸腺瘤CT表现特征.方法 经病理证实的15例侵袭性胸腺瘤均行CT平扫加增强检查,分别对病变的形态、密度、强化方式、周围结构侵犯及种植情况进行回顾性分析.结果 15例肿瘤均表现为边缘分叶、不规则,密度不均,平扫CT值40～50HU,其中坏死囊变11例,点状钙化4例;15例均有纵隔结构侵犯,周围脂肪间隙模糊、消失,其中大血管侵犯9例,心包侵犯（心包积液）5例,胸膜肺界面不清8例,胸腔积液6例;增强扫描见肿瘤实质部分呈轻至中度强化,CT值增加10～20HU,坏死囊变不强化.结论 侵袭性胸腺瘤CT表现具有一定特征,螺旋CT能显示肿瘤内部改变,又能显示周围组织受侵犯情况,具有较高诊断价值.

Objective To study CT features of invasive thymoma. Methods 15 cases of invasive thymoma underwent CT scan and enhanced inspection onfirmed by pathology. The lesion morphology, density, the strengthen the way around structure violations and planting were reviewed retrospectively. Results 15 tumors showed as the edge of the leaf, irregu- lar, uneven density, the Unenhanced CT value 40~50 HU, 11 cases had cystic necrosis and 4 cases showed punctgte calci- fication; 15 cases showded invasion of the mediastinal structures infringement fat around the gap blur and disappear; 9 big vascular invasion, 5 pericardium （pericardial effusion）, 8 the pleuropulmonary interface unclear, 6 pleural effusion; the substantial part of the tumor enhanced scan showed mild to moderate strengthen, the CT values increased by 10~20 HU, the cystic necrosis not strengthen. Conclusion The characteric CT findings of invasive thymoma could be revealed, spiral CT can show the tumor internal change, the surrounding tissue and can show the violation, has a high diagnostic value.