摘要
目的旨在探讨多层螺旋CT扫描对B3型纵隔胸腺瘤诊断及术后复查的应用价值。方法对2015年1月至2018年5月于我院就诊的42例B3型纵隔胸腺瘤患者的临床资料进行回顾性分析,收集所有患者性别、年龄等临床和相关影像学资料,根据资料总结B3型纵隔胸腺瘤手术前后在多层螺旋CT平扫及增强检查中的图像特征,且以手术过程病理活检结果为标准,比较不同检查方法对B3型纵隔胸腺瘤诊断的正确率及在术后复查中的应用价值。结果42例B3型纵隔胸腺瘤患者共72个病灶,多层螺旋CT增强检查其病灶检出率和平扫比较(97.22%vs94.44%)无差异(P>0.05),但增强诊断符合率均显著高于多层螺旋CT平扫检查(χ2=4.086,P=0.043);术前在多层螺旋CT平扫中,绝大部分显示在前纵隔处可见类圆形或类椭圆形高密度或混杂密度影的软组织块,且密度不均匀,病灶边缘与前部心包分界不清,局部心包显示增厚。可有局灶钙化,少数呈小的弧形钙化。而在增强扫描中,前纵隔所见病灶在动脉期呈不均匀明显强化,内见不明显强化坏死区,且病灶边缘与前部心包局部分界不清,而在静脉期病灶显示持续不均强化。而术后复查多层螺旋CT平扫示前纵隔肿块处较术前比较明显消散且存在少许絮状物,前部心包局部稍增厚。结论多层螺旋CT扫描检查对B3型纵隔胸腺瘤的检出及诊断均具有一定的临床价值,但其中增强扫描检查较平扫而言,其诊断符合率更高,可更为清晰的显示出病灶的内部结构及其与周围组织的关系,更有利于指导临床诊断和治疗。
Objective To investigate the application value of multi-slice spiral CT scan in the diagnosis and postoperative review of type B3 mediastinal thymoma.Methods The clinical data of 42 patients with type B3 mediastinal thymoma who treated in our hospital from January 2015 to May 2018 were analyzed retrospectively.The clinical data and related imaging data of all patients were collected.According to the data,the imaging features of B3 type mediastinal thymoma before and after operation in multi-slice spiral CT plain and the enhanced examination were summarized.The results of pathological biopsy during surgical procedures were used as the standard to compare the correct rate of different examination methods for the diagnosis of type B3 mediastinal thymoma and its application value in postoperative review.Results A total of 72 lesions were found in 42 patients with B3 type mediastinal thymoma.There was no difference in the detection rate of the lesions and plain scan between the two groups(97.22%vs 94.44%)(P>0.05).However the coincidence rate in enhanced diagnosis was significantly higher than that in multi-slice spiral CT(χ2=4.086,P=0.043),in the multi-slice spiral CT plain scan efore operation,most of the soft tissue demonstrated round or oval shape high density or mixed density lesions in the anterior mediastinum.The density was not uniform,the boundary between the edge of the lesion and the anterior pericardium is unclear,and the local pericardium was thickened.There was focal calcification in lesions,and a few lesions presented small curved calcification.In the enhanced scan,the lesions seen in the anterior mediastinum showed uneven enhancement in the arterial phase.It is not obvious that the necrotic area is strengthened inside,and the boundary between the edge of the lesion and the anterior pericardium is unclear,while the lesion in the venous phase showed persistent uneven enhancement.Through postoperative review,the multi-slice spiral CT scan showed that the anterior mediastinal mass was significantly dissipated,and there was a little flocculation and the anterior pericardium was slightly thickened.Conclusion Multi-slice spiral CT scan has certain clinical value for the detection and diagnosis of B3 type mediastinal thymoma.Compared with plain scan,the diagnostic coincidence rate of enhanced examination is higher,which can clearly show the internal structure of the lesion and the relationship with the surrounding tissue.It is beneficial to guide clinical diagnosis and treatment.
作者
何强
陆纪元
谈炎欢
HE Qiang;LU Ji-yuan;TAN Yan-huan(Department of Radiology,Changshu Traditional Chinese Medicine Hospital,Changshu 215500,Jiangsu Province,China)
出处
《中国CT和MRI杂志》
2020年第1期69-71,共3页
Chinese Journal of CT and MRI
基金
江苏省卫计委科研项目(P201620).
关键词
多层螺旋CT
B3型纵隔胸腺瘤
影像学特征
应用价值
Multi-slice Spiral CT Plain Scan
Enhancement
Typeb3 Mediastinal Thymoma
Imaging Features
Application Value
作者简介
通讯作者:何强
