CAJ | 학술논문

_目的：对胸腺上皮肿瘤的 MSCT-手术-病理进行对照分析，为术前诊断、分期、治疗方式的选择及预后评价提供依据。方法：对84例经病理确诊为胸腺上皮肿瘤患者的临床、病理及影像学资料进行回顾性对照分析。结果：胸腺上皮肿瘤大多（64．3％，54/84）位于中线一侧，多呈椭圆形（66．7％，56/84），部分边缘可见肿块-肺界面（MPI）增厚呈尖角或锯齿征（46．4％，39/84）及肿瘤的肿块-大血管心脏面（MCI）呈灌铸式生长（44．0％，37/84），内部可见钙化灶、坏死及囊变区，少数可见大血管侵犯（15．5％，13/84）、胸膜或心包结节（14．3％，12/84）、胸腔或心包积液（13．1％，11/84）及纵隔淋巴结肿大（13．1％，11/84），极少发生肺转移（2．4％，2/84）。MCI 呈灌铸式生长诊断胸腺上皮肿瘤侵犯邻近心脏大血管的敏感度为54．5％，特异度为87．0％。MPI 增厚呈尖角或锯齿状诊断胸腺上皮肿瘤侵犯邻近纵隔-肺的敏感度为63．6％，特异度为91．7％。结论：MSCT 能准确显示胸腺上皮肿瘤的内部结构、邻近组织侵犯及胸膜、肺转移。
_목적：대흉선상피종류적 MSCT-수술-병리진행대조분석，위술전진단、분기、치료방식적선택급예후평개제공의거。방법：대84례경병리학진위흉선상피종류환자적림상、병리급영상학자료진행회고성대조분석。결과：흉선상피종류대다（64．3％，54/84）위우중선일측，다정타원형（66．7％，56/84），부분변연가견종괴-폐계면（MPI）증후정첨각혹거치정（46．4％，39/84）급종류적종괴-대혈관심장면（MCI）정관주식생장（44．0％，37/84），내부가견개화조、배사급낭변구，소수가견대혈관침범（15．5％，13/84）、흉막혹심포결절（14．3％，12/84）、흉강혹심포적액（13．1％，11/84）급종격림파결종대（13．1％，11/84），겁소발생폐전이（2．4％，2/84）。MCI 정관주식생장진단흉선상피종류침범린근심장대혈관적민감도위54．5％，특이도위87．0％。MPI 증후정첨각혹거치상진단흉선상피종류침범린근종격-폐적민감도위63．6％，특이도위91．7％。결론：MSCT 능준학현시흉선상피종류적내부결구、린근조직침범급흉막、폐전이。
To analyze CT findings of thymic epithelial tumors for the purpose of enabling preoperative di-agnoses,staging,treatment planning,and prognostic evaluation.Methods:Clinical,histopathological and imaging data of 84 patients who were pathologically confirmed of thymic epithelial tumors were reviewed retrospectively.Results:Most thymic epithelial tumors were unilateral in the anterior mediastinum.Most masses were oval shaped (66.7%)and some of them had peripheral lumps.Mass-pulmonary interfaces (MPI)displayed sharp angles or saw-tooth configuration (46.4%).Mass-cardiovascular interfaces (MCI)displayed casting-like growth (44.0%),which contained calcification,necrosis,and cystic changes.Some displayed invasion into the great vessels (15.5%),pleural or pericardial nodules (14.3%),pleural or peri-cardial effusion (13.1%),and mediastinal lymph node enlargement (13.1%).Lung metastases were rare (2.4%).Casting-like growth in MCI had a sensitivity of 54.5% and specificity of 87.0% in suggesting thymic epithelial tumor invasion to adjacent great vessels.Sharp angle or saw-tooth shape within MPI had a sensitivity of 63.6% and specificity of 91.7% in suggesting thymic epithelial tumor invasion to mediastinum or lung.Conclusion:MSCT can accurately show internal struc-ture,adjacent tissue invasion,pleural or lung metastases of thymic epithelial tumors.