不同CT征象对胸腺瘤与常见纵隔恶性肿瘤的诊断及鉴别诊断

摘要

Objective:To investigate the different CT signs of mediastinal thymoma and common malignancy diag-nosis and differential diagnosis. Methods:After surgery and biopsy and clinical follow-up confirmed 90 cases of me-diastinal tumors included non-invasive thymoma 30 cases,28 cases of invasive thymoma and mediastinal 32 cases of malignant tumors. All patients underwent unenhanced and enhanced scans using dynamic contrast-enhanced MSCT and MPR imaging to analyse three types of mediastinal tumor CT image features,compare the basic characteristics of tumor differentiation. Results:Dynamic contrast-enhanced MSCT imaging technology and MPR technology analysis showed non-invasive thymoma patients with CT imaging of morphological in 28 cases,2 cases due to the rules, smooth edge in 27 cases,3 cases less smooth,rough 0 case,density 27 cases,less uniform three cases with invasive thymoma and mediastinal malignancies whether CT imaging of morphological rules,the edge was smooth,the density was uniform obvious differences,pairwise comparisons were significant differences(P<0. 05). MCI form of non-in-vasive thymoma patients with CT imaging in 27 cases of protruding type,flat type 3 cases,filling the mold 0 case,29 cases clear space around the organs,and some level of clarity one case,the gap was not clear 0 case,30 cases sur-rounding tissue boundaries clear,unclear boundaries 0 case with invasive thymoma and mediastinal malignancies CT imaging MCI morphological types,as well as the surrounding organs were clear gaps surrounding tissue boundaries were clear differences significant pairwise comparison(P<0. 05). Through dynamic enhanced MSCT technology and MPR technical analysis,non-invasive thymoma patients with CT imaging hardened,the intensity did not change sig-nificantly in 24 cases,six cases of mild enhancement,heterogeneous enhancement 0 case accompanied by pleural effu-sion,pleural effusion 29 cases no,mediastinal,armpits and neck almost no patients had lymph nodes with invasive thy-moma and mediastinal malignancies enhanced CT imaging features,whether accompanied by chest differences effu-sion,with or without lymph node enlargement significantly ,pairwise comparisons with a significant difference( P<0. 05). Conclusion:The use of technology and dynamic contrast-enhanced MSCT MPR technology can clearly dis-tinguish non-invasive thymoma,invasive thymoma and mediastinal malignancies,clinical diagnostics provide techni-cal support.%目的：分析不同CT征象对胸腺瘤与常见纵隔恶性肿瘤的诊断及鉴别诊断临床价值。方法：选择2011年3月-2014年6月期间我院收治的经手术及穿刺病理及临床随访证实的90例纵隔肿瘤患者，其中非侵袭性胸腺瘤30例，侵袭性胸腺瘤28例，纵隔恶性肿瘤32例。所有肿瘤患者均行平扫及增强扫描，利用MSCT的动态增强及MPR成像，分析三种类型纵隔肿瘤的CT图像特征，比较三种肿瘤基本特点的差异性。结果：经过MSCT的动态增强技术及MPR技术成像分析，非侵袭性胸腺瘤患者CT成像的形态规则28例，欠规则2例，边缘光滑27例，欠光滑3例，毛糙0例，密度均匀27例，欠均匀3例，与侵袭性胸腺瘤和纵隔恶性肿瘤CT成像的形态是否规则、边缘是否光滑、密度是否均匀的差异性比较明显，两两比较均具有显著性差异（ P<0.05）。非侵袭性胸腺瘤患者CT成像的MCI形态凸出型27例，平坦型3例，灌注型0例，周围脏器间隙清晰29例，部分层面清晰1例，间隙不清晰0例，周围组织分界清晰30例，分界不清0例，与侵袭性胸腺瘤和纵隔恶性肿瘤CT成像的MCI形态类型、周围脏器间隙是否清晰以及周围组织分界是否清晰差异性显著，两两比较具有明显差异性（ P<0.05）。经过MSCT的动态增强技术及MPR技术分析，非侵袭性胸腺瘤患者CT成像经过强化，强度变化不明显24例，轻度强化6例，不均匀强化0例，伴有胸腔积液1例，无胸腔积液29例，纵隔、腋窝与颈部基本无患者具有肿大淋巴结，与侵袭性胸腺瘤和纵隔恶性肿瘤CT成像的强化特点、是否伴有胸腔积液、有无肿大淋巴结等差异性显著，两两比较具有明显差异性（ P<0.05）。结论：利用MSCT动态增强技术和MPR技术，能够明显区分非侵袭性胸腺瘤、侵袭性胸腺瘤与纵隔恶性肿瘤，为临床诊断提供了技术支持，是一种值得推广的区分三种类型肿瘤的鉴别方法。