螺旋CT在低危、高危胸腺瘤及胸腺癌鉴别诊断中的应用

目的探讨螺旋CT在低危、高危胸腺瘤及胸腺癌中的鉴别诊断的应用价值。方法对我院2009年1月～2012年7月收治的54例低危、高危胸腺瘤及胸腺癌患者的CT表现进行回顾性分析,比较三种疾病患者CT表现差异。结果胸低危胸腺瘤组、高危胸腺瘤组和胸腺癌组患者间病变位置分布无统计学差异（P〉0.05）,然而病变位于左侧显著多于右侧,差异具有统计学意义（P〈0.05）。胸腺癌组患者肿瘤边缘多为分叶不规则状,与低危胸腺瘤组、高危胸腺瘤组相比,差异具有统计学意义（P〈0.05）;高危胸腺瘤组与胸腺癌组肿瘤坏死发生情况、胸膜转移情况高于低危胸腺瘤组,差异具有统计学意义（P〈0.05）;三组患者间淋巴结或远处转移情况及大血管、心包受侵情况具有统计学差异（P〈0.05）;三组患者间肿瘤钙化、胸腔积液情况无统计学差异（P〉0.05）。结论采用螺旋CT对低危、高危胸腺瘤及胸腺癌进行鉴别诊断具有重要的参考价值,尤其对高危胸腺瘤与胸腺癌的鉴别提供了可靠的客观依据。

Application of spiral CT in differential diagnosis of low-risk and highrisk thymoma and thymiccarcinoma

Objective To analyze the application value of spiral CT in differential diagnosis on low-risk and high-risk thymoma and thymic carcinoma.Methods CT performance of 54 patients with low-risk and high-risk thymoma and thymic carcinoma treated in our hospital from January 2009 to July 2012 were analyzed retrospectively.The difference of CT performance for patients with three kinds of diseases is compared.Results There was no statistical difference in lesion location distribution among low-risk thymoma group,high-risk thymoma group and thymic carcinoma group（P〈0.05）.But the lesion distributed on the left side more than on the right side,which had statistical significance（P〈0.05）.The tumor edge of thymic carcinoma group is mostly lobulated and irregular,which had statistical significance compared with low-risk thymoma group and high-risk thymoma group（P〈0.05）.The incidence of tumor necrosis and pleural metastasis in high-risk thymoma group and thymic carcinoma group was lower that in low-risk thymoma group,which had statistical significance（P〈0.05）.And there was statistical significance in transfer of lymph node and vascular,pericardial invasion among three groups had statistical significance（P〈0.05）.There was no statistical significance in tumor calcification and pleural effusion among three groups（P〈0.05）.Conclusion Applying spiral CT in differential diagnosis on low-risk and high-risk thymoma and thymic carcinoma not only has important reference value,but also provides reliable and objective basis for the differentiation on high-risk thymoma and thymic carcinoma.