囊性胸腺瘤和囊性畸胎瘤的影像学特征及鉴别诊断

Imaging features and differential diagnosis of cystic thymoma and cystic teratoma

目的 探讨囊性胸腺瘤和囊性畸胎瘤的影像学特征,以提高两者的诊断正确率.方法 回顾性分析经手术后病理证实的18例囊性胸腺瘤和12例囊性畸胎瘤患者的X线及CT影像学表现,所有患者均行X线检查和CT平扫＋增强扫描.结果 肿瘤主要局限在前上纵隔或部分延伸至前中纵隔,而且大多数肿瘤多偏向一侧.囊性胸腺瘤有明显分叶,肿瘤几乎囊变,部分可见小壁结节,邻近血管结构多受推移,部分病灶可压迫肺组织;部分肿瘤可继发胸部改变如胸腔积液等.畸胎瘤基本上都含有囊变,但肿瘤内未见明显骨性及脂性成分,肿瘤内密度不均匀,肿瘤并不是完全囊变.结论 囊性胸腺瘤与囊性畸胎瘤各自具有一定的病理学及影像学特征,根据其影像特征并结合其临床表现,能对两者进行鉴别诊断.

Objective To improve the diagnostic accuracy rate of cystic thymoma and cystic teratoma by investigating their imaging features and differential diagnosis.Methods Retrospectively analyzed the X-ray and CT scanning images of 30 patients, including 12 cases of cystic teratoma and 18 cases of cystic thymoma, which were confirmed via surgery and pathology.Results All of the tumors were localized in the anterior mediastinum, except in one case wherein the tumor extended into the middle mediastinum.In addition, the majority of masses were biased on one side.The cystic thymoma cases showed obvious leaf and were cystic;several tumors also exhibited small mural nodules.Moreover, the adjacent vascular structures were pushed, the lung tissue was compressed by some lesions, and part of the tumor may be secondary to breast changes, such as pleural effusion.All of the teratoma cases were cystic, although no significant bone and fat components were found in the tumor.The density of cystic teratoma was also heterogeneous but not completely cystic.Conclusion Cystic thymoma and cystic teratoma exhibited certain pathological and imaging features, and can be accurately diagnosed based on their features and clinical manifestations.