摘要
目的:探讨CT增强检查对胸腺上皮性肿瘤分型诊断的意义。方法:回顾性选取2008年1月—2023年4月于汕头大学医学院第一附属医院行CT检查并经手术及病理证实的胸腺上皮性肿瘤患者80例,按第五版WHO病理分类法进行分组,分析各组之间的年龄、性别、临床症状、肿瘤内纤维分隔、强化程度、大小、分叶、钙化、坏死或囊变、胸膜侵犯、心包侵犯、大血管侵犯、淋巴结转移、远处转移、瘤-肺交界面、正常胸腺组织侵犯、心包积液及胸水的差异性。结果:胸腺上皮性肿瘤各型之间的临床症状及CT表现有一定的差异。其中重症肌无力在B1(11/16)、B2(2/11)及B3(50/10)型胸腺瘤多见。AB型胸腺瘤内粗大纤维有统计学差异(18/26)。坏死在AB型胸腺瘤内少见(2/26),在B3型胸腺瘤(8/10)及胸腺癌(9/10)中常见。胸膜侵犯多见于B2(6/11)、B3(9/10)型胸腺瘤及胸腺癌(8/10)。心包侵犯也多见于B2(6/11)、B3(10/10)型胸腺瘤及胸腺癌(8/10),其中B3型胸腺瘤(3/10)及胸腺癌(8/10)可突入心包。大血管侵犯(6/10)及淋巴结转移(9/10)主要见于胸腺癌。结论:多期增强CT检查能反映胸腺上皮性肿瘤的纤维分隔、淋巴结转移及对心包、大血管的侵犯等特点,在其分型诊断中有重要意义。
Objective To explore the significance of CT enhancement in the classification and diagnosis of thymic epithelial tumors.Methods 80 patients with thymic epithelial tumors who underwent CT examination and confirmed by surgery and pathology at the First Affiliated Hospital of Shantou University School of Medicine from January 2008 to April 2023 were retrospectively selected.Differences in age,sex,clinical symptoms,intratumoral fibrous separation,degree of enhancement,size,lobular shapes,calcification,necrosis,or cystic change,pleural invasion,pericardial invasion,macrovascular invasion,lymph node metastasis,distant metastasis,tumor-lung interface,normal thymus invasion,pericardial effusion,and pleural effusion were analyzed among the groups.Results There were some differences in the clinical symptoms and CT findings of different types of thymic epithelial tumors.Myasthenia gravis was more common in thymoma of type B1(11/16),B2(2/11)and B3(50/10).There was a statistical difference of large fibrous separation in AB thymoma(18/26).Necrosis was rare in AB thymoma(2/26)but common in B3 thymoma(8/10)and thymic carcinoma(9/10).Pleural invasion was more common in type B2(6/11),B3(9/10)thymoma and thymic carcinoma(8/10).Pericardial invasion was also more common in type B2(6/11)and type B3(10/10)thymoma and thymoma(8/10),among which type B3(3/10)and thymoma(8/10)could burst into the pericardium.Major vascular invasion(6/10)and lymph node metastasis(9/10)were mainly seen in thymic carcinoma.Conclusion Multi-stage CT scan can reflect the histological features of thymic epithelial tumors,and has important significance in its classification and diagnosis.Multi-phase enhanced CT can reflect the characteristics of thymic epithelial tumors,such as fiber separation,lymph node metastasis and invasion of pericardium and macrovascular,and has important significance in the classification and diagnosis of thymic epithelial tumor.
作者
梁恺
张建发
LIANG Kai;ZHANG Jianfa(Radiology Department,The First Affiliated Hospital of Shantou University Medical College,Shantou,Guangdong 515041,China)
出处
《影像研究与医学应用》
2023年第16期19-24,共6页
Journal of Imaging Research and Medical Applications
关键词
胸腺瘤
胸腺癌
CT增强
病理
Thymoma
Thymic carcinoma
CT enhancement
Pathology
