CT诊断非侵袭性胸腺瘤和侵袭性胸腺瘤的价值探讨

The Study on CT Diagnosis Value of Noninvasive Thymoma and Invasive Thymoma

目的探讨CT对非侵袭性胸腺瘤和侵袭性胸腺瘤的临床诊断意义。方法结合临床、手术、病理,回顾性分析12例非侵袭性胸腺瘤及16例侵袭性胸腺瘤的CT表现。结果 12例非侵袭性胸腺瘤,肿瘤最大径<10cm10例,边缘光滑9例,形态规则10例,密度均匀9例;16例侵袭性胸腺瘤,肿瘤最大径≥10cm者10例,边缘不光滑12例,形态不规则13例,密度不均匀13例,另外纵隔淋巴结肿大6例,大血管侵犯4例,出现胸膜转移9例,胸腔积液5例,心包侵犯4例,肺部转移3例,与病理结果对比,这些指标CT均有较高的诊断敏感度及阳性预测值,其中CT对纵隔淋巴结肿大、胸腔积液、肺部转移阳性预测值为100%,各个指标的阴性预测值也很高。结论 CT的影像学特征能够有效鉴别将侵袭性胸腺瘤与非侵袭性胸腺瘤;CT在判断侵袭性胸腺瘤局部侵犯和转移上有较高的可靠性。

Objective To investigate the CT diagnosis value of noninvasive thymoma and invasive thymoma. Methods The CT findings of 12 cases noninvasive thymoma and 16 cases invasive thymoma were retrospectively analyzed with the combination of clinical manifestation, surgery and pathology. Results In 12 cases noninvasive thymoma, the tumor maximum diameter〈10 cm of 10 cases, smooth margins of 9 cases, regular figure of 10 cases, homogeneous density of 9 cases. In 16 cases invasive thymoma, the maximum diameter of tumor≥10 cm of 10 cases, rough edge of 12 cases, irregular shape of 13 cases, uneven density of 13 cases, besides mediastinal enlarged lymph node of 6 cases, macro-vascular invasion of 4 cases, pleural metastasis of 9 cases, pleural effusion of 5 cases, pericardium infringement of 4 cases, lung metastases of 3 cases. These index have higher diagnosis sensitivity and masculine forecast value for CT compared with pathological results. The CT masculine forecast value is 100% in mediastina enlarged lymph node, pleural metastasis and pleural effusion, the index of negative predictive values is high too. Conclusion CT imaging characteristics can effectively identify invasive thymoma and noninvasive thymoma, and have high reliability on local invasion and metastasis of invasive thymoma.