CT预测胸腺瘤的分期及其侵袭性的研究

中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (3): 346-349.

CT预测胸腺瘤的分期及其侵袭性的研究

沈艳^1,2，　叶晓丹¹，　张玉^1,3，　马永红¹，　朱莉¹，　李明华²，　叶剑定¹

1.上海交通大学附属胸科医院放射科，上海 200030； 2.上海交通大学附属第六人民医院放射科，上海 200233；
3.复旦大学附属金山医院放射科，上海 201508

收稿日期:2013-01-20 出版日期:2013-05-25 发布日期:2013-06-06
通讯作者: 叶剑定，主任医师，E-mail: yejianding@126.com E-mail:shenyan1050@126.com
作者简介:沈艳（1974-），女，江苏常州人，主治医生，硕士，主要从事胸部解剖学及影像诊断研究，Tel：13816955031
基金资助:
上海市科学技术委员会课题资助（124119a0100）

Preoperative CT findings of thymoma: prediction of staging and invasion

SHEN Yan ^1,2, YE Xiao-dan ¹, ZHANG Yu ^1,3, MA Yong-hong ¹, ZHU Li ¹, LI Ming-hua², YE Jian-ding ¹

1. Department of Radiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China; 2. Department of Radiology, Shanghai sixth people's hospital, Shanghai Jiaotong University, Shanghai 200233; 3. Department of Radiology, Jinshan hospital, Fudan University, Shanghai 201508

Received:2013-01-20 Online:2013-05-25 Published:2013-06-06

摘要/Abstract

摘要：

目的　探讨CT预测胸腺瘤的分期及侵袭性的价值。方法　回顾性分析经手术病理证实的胸腺瘤79例，根据Masaoka-Koga分期将胸腺瘤分组：A组为（Ⅰ+Ⅱ期）44例，B组（Ⅲ+Ⅳ期）35例，分析两组肿瘤分布、最大横径、形态、密度、内部钙化及与周围组织器官关系等CT特征，预测胸腺瘤的分期及对周围组织的侵袭程度，与Masaoka-Koga病理分期比较。结果　两组肿瘤分布无差异（P=0.418），两组最大横径、形态、密度、内部钙化均不同，P值分别为0.000, 0.000, 0.001, 0.002。CT对胸腺瘤侵袭纵隔脂肪、纵隔胸膜、心包、临近肺组织及大血管的阳性预测值分别为83.67%、76.92%、71.43%、66.67%、80%，阴性预测值分别为80%、96.22%、96.55%、94.83%、97.3%。结论　CT能较好的判断胸腺瘤的侵袭性，区分Ⅰ/Ⅱ期与Ⅲ/Ⅳ期胸腺瘤，从而确定术前需要新辅助治疗的患者，提高手术切除率及肿瘤切除完整性，改善预后。

关键词: 胸腺瘤, 计算机体层摄影, 分期, 侵袭性

Abstract:

Objective　To discuss the value of CT prediction for staging and invasion of thymoma. Methods　CT characteristics of 79 patients of thymoma established by surgery and pathology were reviewed retrospectively. The total of 79 patients divided into two groups: group A includes stageⅠandⅡ, accounting for 44 cases; groups B contains stage Ⅲ+Ⅳ, accounting for 35 cases. Distribution, major axis, morphologic characteristics, density and calcification were analyzed. Correlation between CT characteristics and Masaola-Koga was also analyzed.　Results　Major axis, morphologic characteristics, density and calcification were of significant differences among different grades of Masaoka-Koga classification and the P values are 0.000, 0.000, 0.001, and 0.002, (P<0.05), respectively. There were no significant difference between the two groups of tumor distribution (P=0.418). Positive predictive value of CT characteristics on mediastinal fat, mediastinal pleura, pericardium, adjacent pulmonary parenchyma, as well as blood vessles were 83.67%, 76.92%, 71.43%,66.67%, 80%, respectively, and the negative predictive value were 80%, 96.22%, 95.55%, 94.83%, 97.3%, respectively.　Conclusion　CT imaging can differentiate different stages of thymoma,providing help in evaluating the need of neoadjuvant therapy or not before surgery, therefore, improving the prognosis.

Key words: Thymoma, Computed tomography, Staging, Invasion

中图分类号:

沈艳, 叶晓丹, 张玉, 马永红, 朱莉, 李明华, 叶剑定. CT预测胸腺瘤的分期及其侵袭性的研究[J]. 中国临床解剖学杂志, 2013, 31(3): 346-349.

CHEN Yan, XIE Xiao-Dan, ZHANG Yu, MA Yong-Gong, SHU Chi, LI Meng-Hua, XIE Jian-Ding. Preoperative CT findings of thymoma: prediction of staging and invasion[J]. Chinese Journal Of Clinical Anatomy, 2013, 31(3): 346-349.

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