多层螺旋CT在低危和高危胸腺瘤及胸腺癌鉴别诊断中的价值

Value of multi-slice spiral CT in the differential diagnosis of low-risk and high-risk thymoma and thymic carcinoma

目的 探究多层螺旋CT在低危和高危胸腺瘤及胸腺癌鉴别诊断中的价值。方法 回顾性分析2019年5月至2021年5月在本院经手术及病理证实为低危、高危胸腺瘤与胸腺癌的70例患者,比较低危胸腺瘤、高危胸腺瘤及胸腺癌患者的临床症状,记录其CT特征。结果 低危组患者出现胸痛或胸部其他不适的概率低于胸腺癌组,无症状概率高于高危组及胸腺癌组(P<0.05),3组出现重症肌无力、咳嗽和呃逆等症状的概率差异无统计学意义(P>0.05)。低危组的肿瘤最小直径、肿瘤边缘光滑概率大(高)于高危组和胸腺癌组,胸腔积液和胸膜转移概率低于高危组,坏死概率低于胸腺癌组(P<0.05);高危组肿瘤边缘光滑概率高于胸腺癌组(P<0.05);低危、高危组大血管受侵、肺受侵、淋巴结及远处转移、心包受侵、灌铸式生长发生率低于胸腺癌组,而强化均匀概率高于胸腺癌组(P<0.05);3组患者关于其他CT表现的检出率差异无统计学意义(P>0.05)。结论 多层螺旋CT对于低危、高危胸腺瘤和胸腺癌的鉴别诊断具有一定鉴别价值。

Objective To explore the value of multi-slice spiral CT in the differential diagnosis of low-risk and high-risk thymoma and thymic carcinoma.Methods A retrospective analysis was performed on 70 patients with low-risk and high-risk thymoma and thymic carcinoma confirmed by surgery and pathology in the hospital between May 2019 and May 2021.The clinical symptoms in patients with low-risk thymoma,high-risk thymoma and thymic carci-noma were compared,and their CT characteristics were recorded.Results The incidence of chest pain or other chest discomforts in the low-risk group was significantly lower than that in thymic carcinoma group,and incidence of asymp-tomatic status was higher than that in the high-risk group and thymic carcinoma group(P<0.05).There was no signifi-cant difference in the incidence of myasthenia gravis,cough,and hiccups among the three groups(P>0.05).The mini-mum tumor diameter and incidence of smooth tumor margin in the low-risk group were higher than those in the high-risk group and thymic carcinoma group,the incidence of pleural effusion and pleural metastasis was lower than that in high-risk group,and the incidence of necrosis was lower than that in thymic carcinoma group(P<0.05).The incidence of smooth tumor margin in high-risk group was higher than that in thymic carcinoma group(P<0.05).The incidence of aorta invasion,lung invasion,lymph node and distant metastasis,pericardial invasion,filling growth in low-risk group and high-risk group were lower than those in carcinama group,while uniform enhancement in the low-risk group and the high-risk group was higher than that in thymic carcinoma group(P<0.05).There was no significant difference in detection rates of the other CT findings among the three groups(P>0.05).Conclusion The multi-slice spiral CT has a certain value in the differential diagnosis of low-risk thymoma,high-risk thymoma,and thymic carcinoma.