摘要
目的:探讨MSCT平扫并增强CT在胸腺癌中的诊断价值。方法:回顾性分析本院2013年5月～2018年6月37例术前CT诊断胸腺癌MSCT平扫并双期增强扫描资料,观察病变的位置、形态、大小、密度(CT值)、增强特点及周围侵犯、纵膈淋巴结转移等CT特点。结果:本组37例术前CT全部诊断胸腺癌,术后病理诊断全部为恶性肿瘤,其中胸腺癌28例,侵袭性胸腺瘤9例。全部28例胸腺癌均为前上纵膈单发病灶,最大截面位于中线7例,偏于纵膈一侧21例,差异具有统计学意义(P<0.05);病变形态全部呈不规则分叶状,病灶最小径为2.1 cm,最大径为8.6 cm;实性部分均以软组织密度为主;全部胸腺癌病例病灶增强后动脉期、静脉期显示不均匀中重度强化,静脉期强化程度高于动脉期,内部不规则液化坏死区无强化;病变内部伴坏死灶26例,伴纵膈淋巴结转移21例,伴有邻近胸膜侵犯8例,侵犯纵膈大血管19例,远处胸膜转移0例。结论:MSCT平扫并双期增强CT有利于显示胸腺癌肿块细节及转移情况,提高CT诊断与病理诊断符合率,降低误诊率。为临床诊断、治疗胸腺癌提供帮助。
Objective: To evaluate the value of MSCT plain scan and enhanced CT in the diagnosis of thymic adenocarcinoma. Methods: From May 2013 to June 2018, 37 cases of MSCT plain scan and dual-phase enhanced scan of thymic adenocarcinoma were retrospectively analyzed. The location, shape, size, density (CT value), enhanced features, peripheral invasion and mediastinal lymph node metastasis of the lesions were observed. Results: All 37 cases of thymic adenocarcinoma were diagnosed by CT before operation, and all cases were diagnosed by pathology after operation as malignant tumors, including 28 cases of thoracic adenocarcinoma and 9 cases of invasive thymoma. All 28 cases of thymic adenocarcinoma were single lesion of anterior superior mediastinum. The maximum cross-section was located in the midline in 7 cases and on the mediastinal side in 21 cases with significant difference ( P <0.05). All lesions were irregular lobulated. The minimum diameter of lesions was 2.1 cm and the maximum diameter was 8.6 cm. Soft tissue density was dominant in the solid part. All cases of thymic adenocarcinoma showed inhomogeneous, moderate and severe enhancement in the arterial and venous phase after enhancement. The degree of enhancement in the venous phase was higher than that in the arterial phase, and there was no enhancement in the irregular liquefied necrosis area. 26 cases had necrotic lesions, 21 cases had mediastinal lymph node metastasis, and 8 cases had invasion of adjacent pleura. 19 cases had mediastinal vessels and 0 cases had distant pleural metastases. Conclusion: MSCT plain scan combined with dual-phase enhanced CT is helpful to display the details and metastasis of thymic adenocarcinoma, improve the coincidence rate of CT diagnosis and pathological diagnosis, and reduce the misdiagnosis rate. To provide help for clinical diagnosis and treatment of thymic adenocarcinoma.
作者
刘冰
杨晓锋
孙婷
邸水香
苏江华
王秀忠
宋宁
何玉芳
LIU Bing;YANG Xiao-feng;SUN Ting;SHA Shui-xiang;SU Jiang-hua;WANG Xiu-zhong;SONG ning;HE Yu-fang(Shijiazhuang First Hospital, Shijiazhuang 050011, Hebei Province, China;Shijiazhuang Health and Epidemic Prevention Station of China Railway Beijing Bureau Group Co., Ltd., Shijiazhuang 050011, Hebei Province, China;Shijiazhuang Second Hospital, Shijiazhuang 050011, Hebei Province, China)
出处
《海南医学院学报》
CAS
2019年第7期548-551,共4页
Journal of Hainan Medical University
基金
石家庄市科技局2016项目(161460663)~~
关键词
胸腺癌
计算机体层摄影术
平扫并双期增强扫描
计算机辅助
Thymic cancer
Computed tomography
Plain and dual-phase enhanced scanning
Computer--assisted imaging
