术前CT诊断在胸腺上皮性肿瘤外科分期中的应用价值

The Value of Preoperative CT Scan on the Surgical Staging of Thymic Epithelial Tumors

目的:利用CT诊断技术对胸腺上皮性肿瘤作出明确临床分期,帮助临床对患者行术前手术评估及为术后治疗提供参考。方法:经病理证实的31例胸腺上皮肿瘤均行CT平扫及增强检查,对病变的形态、密度、强化方式、周围结构有无侵犯及种植情况进行回顾性分析,结合Masaoka-Koga临床分期评估术中所见与CT分期的一致性。结果:在31例胸腺上皮肿瘤手术病理分期中,Ⅰ期14例,Ⅱ期4例,Ⅲ期4例,Ⅳ期9例,其术前CT分期与手术病理分期高度一致。其中肿瘤形状、轮廓、大小、肿瘤内部密度、强化方式、钙化、有或没有相邻结构(纵隔胸膜、肺、心包、纵隔血管)的侵犯与Masaoka-Koga分期均相关。结论:利用CT诊断可以对胸腺上皮性肿瘤的临床分期作出准确评估,并对临床治疗包括手术方案制订提供一定的帮助。

Purpose: To make clear clinical staging of thymic epithelial tumors by using CT diagnostic technology, and provide additional information for preoperative evaluation and postoperative treatment. Methods:Thirty-one cases of thymic epithelial tumors confirmed pathologically underwent plain CT scan and enhanced examination. Retrospective analysis was performed on the morphology, density, enhancement method, surrounding structure invasion, and implantation. Combined with Masaoka-Koga clinical staging assessment, consistency between what we saw during the operation and CT staging was evaluated. Results: Among the 31 cases of thymic epithelial tumors, the pathological staging of the thymic epithelial tumor was 14 in stage Ⅰ, 4 in stage Ⅱ, 4 in stage Ⅲ,and 9 in stage Ⅳ. The preoperative CT stage was highly consistent with the surgical pathological stage. Among them,tumor shape, contour, size, tumor internal density, enhancement method, calcification, and invasion of adjacent structures(mediastinal pleura, lung, pericardium, and mediastinal vessels) were all related to Masaoka-Koga stage.Conclusion: The clinical staging of thymic epithelial tumors can be accurately evaluated by CT diagnosis, and it can provide some help for clinical treatment plans, including surgical planning.