摘要
目的观察不同组织学分型胸腺上皮性肿瘤(TET)的MSCT表现特征。方法回顾性分析108例经手术或穿刺病理证实TET的术前CT表现,并与2004年WHO分型标准比较,探讨不同组织类型TET的CT特征。结果 108例中,A型胸腺瘤3例,AB型30例,B1、B2、B3型分别为15例、29例、9例,胸腺癌22例。合并重症肌无力(MG)者32例(32/108,29.63%)。合并MG患者中,B型胸腺瘤者明显高于其他分型[45.28%(24/53)vs 14.55%(8/55),χ2=12.23,P<0.001]。胸腺癌最大径>5cm者多于胸腺瘤[72.73%(16/22)vs 44.19%(38/86),χ2=5.708,P=0.017]。A、AB、B1型胸腺瘤多呈圆形或卵圆形,B2型多呈分叶状,胸腺癌形态多不规则(χ2=32.917,P<0.001)。B3型胸腺瘤和胸腺癌坏死囊变发生例数分别为6例和10例,明显高于其他胸腺瘤[51.61%(16/31)vs 24.68%(19/77),2χ=7.322,P=0.007]。与B1、B2、B3型相比,A、AB型、胸腺癌强化程度以中度强化为主[58.18%(32/55)vs 30.19%(16/53),2χ=11.820,P=0.001]。胸腺癌影像分期多为Ⅲ期,与其他型分布比较差异有统计学意义[54.55%(12/22)vs 13.95%(12/86),2χ=38.958,P<0.001]。影像分期与临床分期有相关性(r=0.548,P<0.01)。结论不同组织类型TET的CT表现具有一定特征性。CT可在一定程度预测TET组织学类型,提示临床分期及预后。
Objective To observe the MSCT manifestations of different type of thymic epithelial tumors（TETs）.Methods The CT images of 108 cases with TETs confirmed pathologically by surgery or biopsy were reviewed retrospectively.Based on WHO 2004 Classification System,the CT features of different histopathological types of TETs were analyzed.Results In all subjects,type A was 3cases,AB was 30 cases,B1,B2,B3 were 15,29,9cases respectively,and thymic carcinoma was 22cases;32cases（32/108,29.63%）merged with myasthenia gravis（MG）,and type B thymoma was significant higher than other types[45.28%（24/53）vs 14.55%（8/55）,χ^2=12.230,P〈0.001]which merged with MG.The cases with biggest diameter 5cm of thymic carcinoma was more than that of the thymoma（72.73% [16/22]vs44.19% [38/86],χ^2=5.708,P=0.017）.Type A,AB,B1 thymoma were more likely to have spherical or oval shapes,B2 was lobulated and thymic carcinoma was irregular or mould growth（χ2=32.917,P〈0.001）.The cases of necrosis capsule in type B3 thymoma and thymic carcinoma were 6and 10,which was obviously higher than other thymoma（51.61% [16/31]vs 24.68% [19/77],χ^2=7.322,P=0.007）.Compared with B1,B2 and B3,the enhancement of type A,AB and thymic carcinoma showed moderate reinforcement（58.18% [32/55]vs 30.19% [16/53],χ^2=11.820,P=0.001）.Thymic carcinoma in image stage III was higher than other types（54.55% [12/22]vs 13.95% [12/86],χ^2=38.958,P〈0.001）.Imaging stage was correlated with clinical stage（r=0.548,P〈0.01）.Conclusion Different types of TET have different CT features.To some extent,CT has the potential of forecast TET histological types,and reminder clinical stage and prognosis.
出处
《中国医学影像技术》
CSCD
北大核心
2015年第2期253-257,共5页
Chinese Journal of Medical Imaging Technology
