摘要
目的探讨儿童良恶性胸腺疾病的CT影像特点与鉴别,提高儿童胸腺疾病诊断水平。方法回顾性分析2014年8月至2019年5月首都儿科研究所附属儿童医院行CT检查的胸腺疾病患儿的临床资料和影像资料。共入组50例患儿,男32例,女18例,年龄5 d^14.2岁,平均(6±4)岁。根据临床诊断和/或病理结果,将所有患儿分为良性组(22例)与恶性组(28例)。总结并比较良性组和恶性组患儿的临床表现与CT征象(胸腺体积、形态、边界、密度、内部特征、与周围结构关系及强化方式、程度)。结果良性组和恶性组患儿临床表现多样,多以发热就诊,无明显特异性。22例良性组中8例患儿表现为胸腺缺如,均为原发免疫缺陷病,且临床表现均有反复、持续呼吸道感染病史。28例恶性组中20例出现周围及远处侵犯,分别为淋巴结7例、胸膜6例、肺部6例、心包2例、肝2例、脾2例、肾2例、骨1例,其中6例胸膜受累者均为非霍奇金淋巴瘤患儿。2组患儿CT表现比较,胸腺体积缺如及增大、边界、病灶内部坏死、推挤包绕血管、周围或远处侵犯差异有统计学意义(P<0.05);胸腺形态、密度、内部钙化或囊变、强化方式和强化程度差异均无统计学意义(P>0.05)。结论胸腺良性病变CT多表现为胸腺缺如或体积正常、边界清、无坏死、无推挤血管、无周围或远处侵犯;恶性病变CT多为体积增大、边界清晰或模糊、内部可有坏死、推挤包绕血管、周围或远处侵犯。胸腺良、恶性疾病CT表现各有特征,结合临床表现有助于两者的鉴别诊断。
Objective To explore the CT features of benign and malignant thymus diseases in order to improve the diagnostic accuracy of thymus diseases in children.Methods The clinical data and imaging data of children with thymic diseases who underwent CT examination in children′s Hospital Affiliated to Capital Institute of Pediatrics from August 2014 to may 2019 were retrospectively analyzed.There were 32 males and 18 females with an average age of(6±4)years(range 5 days to 14.2 years).According to the clinical diagnosis and/or pathological results,all children were divided into benign group(22 cases)and malignant group(28 cases).The clinical manifestations and CT signs(thymus volume,shape,border,density,internal characteristics,relationship with surrounding structures,enhancement pattern and extent)of benign group and malignant group were summarized and compared.Results The clinical manifestations of benign group and malignant group were varied,and fever was the most common sign.In the benign group,8 cases showed thymus deficiency,all of them were diagnosed as primary immunodeficiency disease,and the clinical manifestations were repeated and persistent respiratory tract infection history.In 28 cases of malignant group,20 cases had peripheral invasion and distant metastasis,including 7 cases of lymph node,6 cases of pleura,6 cases of lung,2 cases of pericardium,2 cases of liver,2 cases of spleen,2 cases of kidney and 1 case of bone.All 6 cases of pleural involvement occurred in children with non Hodgkin′s lymphoma.There were significant differences in CT findings between the two groups(P<0.05);there were no significant differences in terms of shape,density,internal calcification or cystic change,enhancement pattern and enhancement extent of thymus lesions between the two groups(P>0.05).Conclusions Benign lesions of thymus usually manifests as absence or normal size of thymus,well-defined,non-necrotic,no displacement of vessels,no peripheral or distant invasion on CT;whereas malignant lesions are mostly enlarged,well o
作者
韦美玲
袁新宇
郭红伟
闫淯淳
Wei Meiling;Yuan Xinyu;Guo Hongwei;Yan Yuchun(Department of Radiology,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2020年第10期998-1002,共5页
Chinese Journal of Radiology
