增强CT在低危和高危胸腺瘤及胸腺癌鉴别诊断中的应用

目的 分析鉴别低危和高危胸腺瘤及胸腺癌的增强CT检测特征.方法 回顾性分析72例胸腺瘤及胸腺癌患者,分为胸腺癌组(n=30)、低危胸腺瘤组(n=22)和高危胸腺瘤组(n=20).所有患者均行增强CT检测,分析肿瘤最大径、最小径、形态、位置、密度、边缘、是否存在坏死及钙化、是否存在淋巴结转移或远处转移、是否存在心包及大血管侵袭以及是否出现胸腔积液等资料.结果 胸腺癌组患者肿瘤最大径、最小径、肿瘤纵径和增强CT均值均大于高危胸腺瘤组和低危胸腺瘤组(均P＜0.05).胸腺癌组患者淋巴结肿大、大血管侵袭、心包侵袭、边缘分叶及远处转移比例均高于高危胸腺瘤组和低危胸腺瘤组(均P＜0.05).高危胸腺瘤组与低危胸腺瘤组比较,在是否存在坏死、大血管侵袭和心包侵袭方面差异均具有统计学意义(均P ＜0.05).结论 增强CT对低危、高危胸腺瘤及胸腺癌具有良好的鉴别诊断价值.

Enhanced CT in differential diagnosis of low-risk thymoma,high-risk thymoma and thymic carcinoma

Objective To analyze the diagnostic characteristics of enhanced CT in differentiating low-risk thymoma,high-risk thymoma and thymic carcinoma.Methods The imaging findings of enhanced CT in 72 patients with low-risk thymoma (n =22),high-risk thymoma (n =20) or thymic carcinoma (n =30) were retrospectively analyzed.The maximum diameter,minimum diameter,shape,location,density,edge,presence of necrosis or calcification,lymphatic metastasis or distant metastasis,pericardial and macrovascular invasion,and pleural effusion were analyzed.Results The maximum diameter,minimum diameter and height of the tumor,and the enhanced CT value in thymic carcinoma group were all significantly higher than those in high-risk or low-risk thymoma groups (P ＜ 0.05).And the rates of lymphadenectasis,large vessel invasion,pericardium invasion,marginal lobulation and distant metastasis were all higher in thymic carcinoma group than those in high-risk or low-risk thymoma groups (P ＜ 0.05).Furthermore,significant differences were also observed in the presence of necrosis,large vessel invasion and pericardial invasion between high-risk thymoma group and low-risk thymoma group (P ＜ 0.05).Conclusion Enhanced CT is of diagnostic value in differentiating low-risk thymoma,high-risk thymoma and thymic carcinoma.