前纵隔原发性恶性肿瘤的MSCT影像表现

MSCT Imaging Findings in Anterior Mediastinal Primary Malignant Tumors

目的:探讨前纵隔原发性恶性肿瘤的MSCT表现,以提高诊断水平。方法:回顾性分析经病理证实的45例前纵隔原发恶性肿瘤患者的影像及临床资料。结果:45例中有胸腺癌17例,病灶中央见囊变坏死,多数肿块囊变坏死区较多、较大;恶性淋巴瘤14例,呈单个不规则形软组织肿块或多个结节相互融合,并包绕大血管生长,多数肿块周围及(或)其他部位见肿大淋巴结;恶性生殖源性肿瘤12例,其中10例尿绒毛膜促性腺激素(HCG)或血甲胎球蛋白(AFP)水平异常,4例见钙化,3例见脂肪成分;恶性孤立性纤维瘤1例,位于前上纵隔偏左侧,内见囊变坏死,三期增强后呈"渐进性"强化;神经内分泌癌1例,边界清,内见囊变坏死,增强后呈环形强化。结论:前纵隔原发性恶性肿瘤的MSCT表现具有一定的特征性,结合临床特点,有助于对其行准确的诊断及疗效评估。

Objective To investigate the MSCT imaging of anterior mediastinal primary malignant tumors,and to improve the accuracy of diagnosis. Methods The imaging and clinical data of forty-five patients with anterior mediastinal primary malignant tumors were retrospectively analyzed. Results Among all forty-five cases,there were seventeen thymic carcinomas, and cystic and necrotic earas were seen in all cases. Fourteen were malignant lymphomas with a single irregular soft tissue mass or multiple merged nodules. There were enlarge lymph nodes around the tumors and（or） in other parts of the body. Twelve cases were malignant germinomas,the levels of rinary human chorionic gonadotropin（HCG） or blood armour fetuin（AFP） were abnormal in ten cases, and calcifications were seen in four cases and fat composition was observed in three cases. One malignant solitary fibrous tumor was observed on the left side of the anterior-superior mediastinum with cystic degeneration and necrosis. One was neuroendocrine carcinoma with clear boundary, cystic degeneration and necrosis, after enhanced scanning, it showed ring-shaped reinforcement. Conclusion Anterior mediastinal primary malignant tumors have certain characteristics of MSCT findings, in combination with clinical information, which can help the diagnosis and efficacy evaluation.