目的:评价低危、高危胸腺瘤及胸腺癌CT特征,为术前诊断及预后评价提供依据.方法:回顾分析经手术及病理证实的59例低危、高危胸腺瘤及胸腺癌的CT表现,并比较各组病灶差异.结果:胸腺癌较低危胸腺瘤更常见坏死及囊变、不规则、分叶、灌注式生长及肺侵犯. 胸腺癌较低危胸腺瘤及高危胸腺瘤更常表现为不均匀强化、边缘毛糙不清、更长径、心包侵犯、大血管侵犯、心包积液、淋巴结肿大及患者年龄更大;更少见表现为类圆形的形态.低危胸腺瘤较高危胸腺瘤及胸腺癌强化幅度更高、胸膜侵犯更少且更少临床症状.结论:胸腺癌、高危胸腺瘤、低危胸腺瘤3组间的多层CT扫描表现有明显差异,有助于鉴别诊断.%Purpose:To study the CT findings of low-risk and high-risk thymoma and thymic carcinoma,in order to provide the foundation for the preoperative diagnosis and prognostic evaluation.Methods:CT features of 59 low-risk thymoma,high-risk thymoma,and thymic carcinoma cases confirmed by operation and pathology results were reviewed retrospectively.And the differences among the three groups were analyzed.Results:Features of necrosis and cystic changes,irregular and lobular shapes,infiltration growth and lung invasion were more common in thymic carcinomas than that in low-risk thymomas.Features of inhomogeneous enhancement,coarse margins,longer diameter,cardiac and vascular invasion,pericardial effusion and lymph node enlargement were more frequent in thymic carcinomas than that in low-risk thymomas and high-risk thymomas;Round shape was rarely shown in thymic carcinomas.Features of heavy enhancement,less clinical symptoms and pleural invasion were more common in low-risk thymomas than that in high-risk thymomas and thymic carcinomas.Conclusion:There are differences in CT features of low-risk and high-risk thymoma and thymic carcinoma,which is helpful to make the differential diagnosis.
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