前纵隔占位性病变的多层螺旋CT影像学表现及诊断价值

Imaging manifestations and diagnostic value of multi-slice spiral CT in anterior mediastinal space occupying lesion

目的探讨前纵隔占位性病变的多层螺旋CT影像学表现及其诊断价值。方法选择海口市第三人民医院收治的37例前纵隔占位病变患者为研究对象,所有患者均行64排多层螺旋CT扫描,分析影像学特点和诊断准确率。结果 37例患者均经病理学确诊,经CT扫描确诊34例,其中胸腺瘤占61.76%,CT主要表现为囊变、坏死或钙化;淋巴瘤占11.76%,CT表现为多个结节样软组织融合且呈现团块肿物;胸腺囊肿占8.82%,CT表现为有单房型囊性肿块,边界清晰光滑,囊壁有钙化和分隔;胸腺神经分泌癌2例(5.88%),成熟畸胎瘤2例(5.88%),Castleman病1例(2.94%)。CT检查诊断准确度为88.00%,敏感度为91.89%。结论多层螺旋CT在前纵隔占位性病变中诊断的敏感度及准确度均较高,可在临床广泛推广应用。

Objective To study the imaging manifestations and diagnostic value of multi-slice spiral CT in anterior mediastinal space occupying lesions.Methods Thirty-seven cases of anterior mediastinal space occupying lesions treated in the Haikou Municipal Third People′s Hospital served as the study subjects and were diagnosed by 64-slice spiral CT.Then the imaging features and diagnostic accuracy were analyzed.Results All 37 cases were diagnosed by pathology,and there were 34 cases confirmed by multislice spiral CT scanning,in which thymoma accounted for 61.76%,and CT was mainly manifested by cystic degeneration,necrosis and calcification.Lymphoma accounted for 11.76%,and CT showed multiple nodular soft tissue fusion and mass.Thymic cyst accounted for 8.82%,and CT showed a single chamber cystic masses,clear and smooth border,and capsule wall calcification and separation.There were 2 cases（5.88%）of thymic neuroendocrine carcinoma,2 cases（5.88%）of mature teratoma and 1 case（2.94%）of castleman disease.The diagnostic accuracy of CT examination was 88.00% and its sensitivity was 91.89%.Conclusion The sensitivity and accuracy of multi-slice spiral CT were higher in the diagnosis of anterior mediastinal lesions,which can be widely used in clinical practice.