侵袭性与非侵袭性胸腺瘤的影像特征及临床分型特点

Imaging Features and Clinical Classification of Invasive and Non-invasive Thymoma

目的分析侵袭性与非侵袭性胸腺瘤的影像特征及临床分型分期、鉴别诊断。方法选取2013年1月~2018年12月我院经术后病理证实的胸腺瘤患者25例,根据2015年WHO胸腺瘤诊断标准及Masaoka临床分期及对胸腺瘤进行侵袭性和非侵袭性分组,并对胸腺瘤的CT/MR表现与临床分型分期进行分析。结果共25例胸腺瘤患者,其中非侵袭性13例,侵袭性12例。侵袭性胸腺瘤CT表现:肿瘤位置为基本中央型1例、左偏型6例、右偏型5例;肿瘤形态为浅分叶形4例、不规则形8例;肿块周围脂肪间隙为狭窄6例、消失4例、模糊2例;肿瘤无钙化6例、钙化6例;肿瘤包膜完整3例、不完整9例。非侵袭性胸腺瘤CT表现:肿瘤位置为基本中央型3例、左偏型3例、右偏型7例;肿瘤形态为类圆形8例,浅分叶形5例;肿块周围脂肪间隙清晰存在13例;肿瘤无钙化9例,边缘钙化4例;肿瘤包膜完整13例。6例侵袭性胸腺瘤MR表现为等T1WI、长/稍长T2WI信号。结论侵袭性与非侵袭性胸腺瘤各自有一定的影像特征,且与临床分型、分期可能存在联系,根据其影像表现并结合临床症状,可准确鉴别其是否为侵袭性。

Objective To analyze the imaging features,clinical classification,and differential diagnosis of invasive and non-invasive thymoma.Methods 25 patients with thymoma confirmed by postoperative pathology from January 2013 to December 2018 were enrolled.According to the 2015 WHO thymoma diagnostic criteria and Masaoka clinical stage and invasive and non-invasive grouping of thymoma,The CT/MR findings and clinical classification of thymoma were analyzed.Results A total of 25 patients with thymoma,including 13 non-invasive and 12 invasive.CT findings of invasive thymoma: 1 case of central type,6 cases of left partial type,5 cases of right partial type;4 cases of superficial lobular shape and 8 cases of irregular shape;The fat space around the mass was stenosis in 6 cases,disappeared in 4 cases,and blurred in 2 cases;tumor had no calcification in 6 cases,calcification in 6 cases;tumor capsule was intact in 3 cases and incomplete in 9 cases.CT findings of non-invasive thymoma: the location of the tumor was 3 cases of basic central type,3 cases of left partial type,and 7 cases of right partial type;the tumor morphology was round in 8 cases,and shallow lobulated in 5 cases;the fat space around the mass was clear.There were 13 cases;9 cases had no calcification,4 cases had marginal calcification,and 13 cases had tumor capsule intact.6 cases of invasive thymoma showed an equal T1WI,long/slightly long T2WI signal.Conclusion Invasive and non-invasive thymomas have certain imaging features,and may be associated with clinical classification and staging.According to their imaging findings and clinical symptoms,they can be accurately identified as invasive.