原发性前上纵隔肿瘤的MSCT征象及其在鉴别诊断中的价值

发布时间：2018-03-13 12:11

本文选题：肿瘤　切入点：前上纵隔　出处：《重庆医学》2015年34期 　论文类型：期刊论文

【摘要】：目的探讨前上纵隔肿瘤的MSCT影像学表现及其在鉴别诊断中的价值。方法回顾性分析32例经手术病理检查证实的前上纵隔肿瘤患者影像资料。其中,恶性肿瘤19例,良性肿瘤13例。所有影像资料均由2名经验丰富的影像科医师共同阅片分析。结果前上纵隔肿瘤与胸骨后前胸壁间隙、大血管前间隙及弓上头臂血管间隙模糊消失,恶性肿瘤组侵犯心包、胸膜的概率明显高于良性肿瘤组,两组间比较差异有统计学意义(P0.01)。恶性组中,淋巴瘤与精原细胞瘤侵犯大血管前间隙发生率均为100%,发生率高于侵蚀性胸腺瘤(3/5)及胸腺癌(2/3);淋巴瘤与侵蚀性胸腺瘤对头臂血管周围间隙的浸润,发生率分别为71.4%(5/7)和80%(4/5),发生率高于胸腺上皮癌和精原细胞瘤;侵蚀性胸腺瘤多呈偏一侧性生长常伴分叶,发生率为80%,稍高于其他各组(P0.05)。病灶本身强化程度与密度是否均匀及有无钙化方面,良性肿瘤组69.2%(9/13)与恶性前上纵隔肿瘤组100%(17/17)间比较差异无统计学意义(P0.05)。结论 MSCT对于前上纵隔肿瘤诊断与鉴别诊断具有重要价值,判断病灶与胸骨后间隙、大血管前间隙、弓上头臂血管间隙的关系,是否侵犯心包、胸膜,在鉴别诊断中具有不同的价值。
[Abstract]:Objective to investigate the MSCT imaging findings of anterior superior mediastinal tumors and their value in differential diagnosis. Methods the imaging data of 32 patients with anterior superior mediastinal tumors confirmed by surgical and pathological examination were retrospectively analyzed. 13 cases of benign tumors. All the imaging data were analyzed by two experienced radiologists. Results the anterior superior mediastinal tumor and the anterior chest wall space of the sternum, the anterior space of the great vessels and the space of the vascular space of the superior arch and the upper arm of the arch disappeared vaguely. The probability of pericardial invasion and pleural involvement in malignant tumor group was significantly higher than that in benign tumor group, and the difference between the two groups was statistically significant (P 0.01). The incidence of lymphoma and seminoma invading the anterior space of large vessels was 100, which was higher than that of invasive thymoma (3 / 5 / 5) and thymic carcinoma (2 / 3 / 3), and the infiltration of lymphoma and invasive thymoma into the perivascular space of the head and arm. The incidence of invasive thymoma was 71.4 / 7) and 80 / 4 / 5 / 5 respectively, which was higher than that of thymoepithelial carcinoma and seminoma. The incidence rate was 80%, slightly higher than that of other groups (P 0.05). Whether the enhancement degree and density of the lesions were uniform or not, and whether the lesions had calcification or not, There was no significant difference between benign tumor group (69.2 / 9 / 13) and malignant anterior mediastinal tumor group (100 / 17 / 17). Conclusion MSCT is of great value in diagnosis and differential diagnosis of anterior superior mediastinal tumor. The relationship between the vascular space of the upper head and arm, whether the pericardium and pleura are invaded, is of different value in differential diagnosis.
【作者单位】：广西医科大学第四附属医院放射科;
【分类号】：R734.5;R730.44

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