CAJ | 학술논문

目的探讨不同组织类型胸腺上皮性肿瘤(TET)的CT特征.方法回顾性分析133例经手术病理证实TET的CT表现,并根据WHO 2004年标准对所有病例重新进行组织学分型,分析不同组织类型TET的CT特征.各类型间比较采用x2检验.结果 133例TET病理分型A、AB、B1、B2、B3型和胸腺癌分别为10、17、13、46、30和17例.A型(9例,90.0％)、AB型(15例,88.2％)、B1(10例,76.9％)和B2型(31例,67.4％)胸腺瘤多呈圆形或卵圆形,形状规则且边界光滑；而B3型(21例,70.0％)与胸腺癌(15例,88.2％)肿块呈不规则形或铸型生长,且边界不清楚.胸腺癌坏死囊变发生率最高(15例,88.2％),其次为B3型胸腺瘤(19例,63.3％)和A型胸腺瘤(6例,60.0％),B2和B3型胸腺瘤钙化发生率较高(32例,42.1％),明显高于其他类型TET(8例,14.0％；X2=12.20,P＜0.01).A、AB、B3型TET及胸腺癌高度强化的发生率(39例,52.7％),明显高于B1和B2型(8例,13.6％；x2= 22.01,P＜0.01).结论根据WHO 2004标准,不同组织类型的TET的CT表现具有一定特征性,CT在一定程度上具有预测TET组织学类型、判断预后的潜力.
목적 탐토불동조직류형흉선상피성종류(TET)적CT특정.방법 회고성분석133례경수술병리증실TET적CT표현,병근거WHO 2004년표준대소유병례중신진행조직학분형,분석불동조직류형TET적CT특정.각류형간비교채용x2검험.결과 133례TET병리분형A、AB、B1、B2、B3형화흉선암분별위10、17、13、46、30화17례.A형(9례,90.0％)、AB형(15례,88.2％)、B1(10례,76.9％)화B2형(31례,67.4％)흉선류다정원형혹란원형,형상규칙차변계광활；이B3형(21례,70.0％)여흉선암(15례,88.2％)종괴정불규칙형혹주형생장,차변계불청초.흉선암배사낭변발생솔최고(15례,88.2％),기차위B3형흉선류(19례,63.3％)화A형흉선류(6례,60.0％),B2화B3형흉선류개화발생솔교고(32례,42.1％),명현고우기타류형TET(8례,14.0％；X2=12.20,P＜0.01).A、AB、B3형TET급흉선암고도강화적발생솔(39례,52.7％),명현고우B1화B2형(8례,13.6％；x2= 22.01,P＜0.01).결론 근거WHO 2004표준,불동조직류형적TET적CT표현구유일정특정성,CT재일정정도상구유예측TET조직학류형、판단예후적잠력.
Objective To investigate the CT findings of thymic epithelial tumors (TETs).Methods The CT images of 133 cases with TETs confirmed pathologically were reviewed retrospectively.The TETs were reclassified according to WHO 2004 Classification System.The CT features of different histopathological types of TETs were analyzed.The frequencies of demonstrating these CT features were compared between different types using Chi-square exact test.Results Type A(9/10,90.0％),AB(15/17,88.2％),B1 (10/13,76.9％ ),and B2( 31/46,67.4％ ) tumors were more likely to have spherical or oval shapes and smooth contours on CT.TETs with irregular or lobular contours were mostly seen in type B3 (21/30,70.0％ )and thymic carcinoma (15/17,88.2％ ).TETs with cyst and necrosis formation were common in type A(6/10,60％ ),B3 ( 19/30,63.3％ ) and thymic carcinoma ( 15/17,88.2％ ).Calcification was more frequently seen in type B2 and B3 (32/76,42.1％ ) than any other type ofTETs (8/57,14.0％ ;x2 =12.20,P ＜ 0.01 ).Type A,AB,B3 and thymic carcinoma had higher prevalence of significant enhancement (39/74,52.7％) than type B1 and B2 (8/57,13.6％;x2=22.01,P＜0.01).Conclusion According to WHO 2004 histologic classification system,different types of TET have corresponding CT features.CT has showed the potentiality in differentiating histological subtypes of TETs.