螺旋CT对侵袭性胸腺瘤与非侵袭性胸腺瘤的鉴别诊断价值

Differential Diagnosis of Invasive and Noninvasive Thymoma by Spiral CT

目的 用螺旋CT(spiralCT ,SCT)扫描评价胸腺瘤侵袭与否的临床价值。方法 收集了经病理证实的胸腺瘤共2 5例 ,其中侵袭性胸腺瘤 (invasivethymoma ,IT) 11例 ,包括 2例胸腺癌 ;非侵袭性胸腺瘤 (noninvasivethymoma ,NIT) 14例 ,通过分析胸腺瘤的各种表现和强化形式以及与纵隔结构的关系判断其侵袭与否 ,并与外科手术对照。结果 ①IT大多表现为分叶状或不规则轮廓 (9/ 11,占 81.8% ) ,强化不均匀中心低密度 (8/ 11,占 72 .7% ) ,对纵隔结构侵犯 (11/ 11,占10 0 % ) ,2例胸腺癌均表现为肺内转移 ;②NIT表现为类圆形 ,有完整的包膜 (14 / 14 ,占 10 0 % ) ,肿瘤强化大多呈均匀一致(12 / 14 ,占 85 .7% ) ,对纵隔结构均无侵犯。结论 螺旋CT对胸腺瘤侵袭性与非侵袭性的诊断有较高的准确性。

Objective Use spiral CT to differentiate invasive from noninvasive thymoma. Methods Of 25 cases with spiral CT scanning and pathologically proved thymoma, there were invasive thymoma in 11 cases (2 cases thymic carcinoma), noninvasive thymoma in 14 cases. The features of enhanced spiral CT and the correlationship between the mediastinal structures and the invasive thymomas were analyzed. Results ① Invasive thymomas were more likely to have lobulated or irregular contours (9/11, 81.8%),heterogeneous enhancement and low attenuation areas within the tumor (8/11, 72.7%).Two cases of thymic carcinoma displayed lung metastases.②Noninvasive thymomas were more likely to be in round, completed encapsulation (14/14, 100%), homogeneous enhancement (12/14,85.7%). Conclusion It was accurate to using spiral CT to differentiate the invasive from noninvasive thymoma.