多层螺旋CT特征对肿块样胸腺增生和低危胸腺瘤的鉴别诊断

Multi-Slice CT Features in the Differential Diagnosis Between Mass-Like Thymic Hyperplasia and Low-Risk Thymoma

目的 探讨多层螺旋CT特征对肿块样胸腺增生和低危胸腺瘤的鉴别诊断价值。资料与方法 回顾性分析2015年9月—2019年11月于唐都医院经手术病理证实的18例胸腺增生和29例低危胸腺瘤的CT及临床资料。CT分析参数包括肿块部位、平均径、最大径、形态、均质性、钙化、平扫和增强CT值、净强化值等,比较肿块样胸腺增生组和低危胸腺瘤组CT指标的差异。结果 肿块样胸腺增生多位于中线区(15/18,83.3%),低危胸腺瘤多为偏侧型(19/29,65.5%),两组肿块部位差异有统计学意义(χ^(2)=10.645,P=0.001)。肿块样胸腺增生和低危胸腺瘤的最大径分别为(5.05±2.37)cm和(6.23±2.54)cm,差异无统计学意义(t=1.594,P=0.118);两组平均径分别为(4.99±1.95)cm和(3.30±1.49)cm,差异有统计学意义(t=3.140,P=0.003)。两组肿块形态差异有统计学意义(χ^(2)=7.860,P=0.005)。肿块样胸腺增生多呈复合形(11/18,61.1%),而低危胸腺瘤多为类圆形(23/29,79.3%)。两组平扫、动脉期和静脉期CT值、净强化值差异均有统计学意义(t=4.315、4.644、4.126、2.764,P均<0.01)。结论 肿块样胸腺增生和低危胸腺瘤的生长部位、平均径、形态和净强化值等特征存在一定的差异,多层螺旋CT特征对鉴别两者具有重要价值。

Purpose To explore the value of multi-slice CT(MSCT) features in the differential diagnosis of mass-like thymic hyperplasia and low-risk thymoma. Materials and Methods The CT and clinical data of 18 cases of thymic hyperplasia and 29 cases of low-risk thymoma confirmed by surgery and pathology in TangDu Hospital from September 2015 to November 2019 were retrospectively analyzed.CT features including tumor location, average diameter, maximum diameter, shape, homogeneity, calcification, non-enhanced and enhanced CT value, and net enhancement degree were compared between the mass-like thymic hyperplasia and low-risk thymoma groups. Results Mass-like thymic hyperplasia was primarily located in the midline area of the anterior mediastinum(15/18, 83.3%), and low-risk thymoma was mostly lateral(19/29, 65.5%), and there was statistically significant difference in position between the two groups(χ^(2)=10.645, P=0.001).The largest diameters of mass-like thymic hyperplasia and low-risk thymoma were(5.05±2.37) cm and(6.23±2.54) cm, respectively, and there was no statistically significant difference in largest diameters between the two groups(t=1.594, P=0.118). The average diameters of mass-like thymic hyperplasia and low-risk thymoma were(4.99±1.95) cm and(3.30±1.49) cm, respectively, and there was statistically significant difference in average diameters between the two groups(t=3.140, P=0.003). There was a statistically significant difference in shape between the two groups(χ^(2)=7.860, P=0.005). The mass-like thymic hyperplasia was complex in shape(11/18, 61.1%), while the low-risk thymoma was oval(23/29, 79.3%). There were significant differences in plain CT value, arterial phase CT value, venous phase CT value and net enhancement value between the two groups(t=4.315, 4.644, 4.126, 2.764, all P<0.01). Conclusion There are certain differences in CT features, such as growth position, average diameter, shape, and net enhancement value, between mass-like thymic hyperplasia and low-risk thymoma. MSCT is of great importance in distinguishing mass-like thymic hyperplasia from low-risk thymoma.