实用医学杂志
實用醫學雜誌
실용의학잡지
The Journal of Practical Medicine
2015年
18期
3039-3042
,共4页
纵隔肿瘤%体层摄影术,X线计算机%诊断
縱隔腫瘤%體層攝影術,X線計算機%診斷
종격종류%체층섭영술,X선계산궤%진단
Mediastinum%Malignant tumor%Tomography%X-ray computed%Diagnosis
目的：探讨前纵隔原发性恶性肿瘤的MSCT表现，以提高诊断水平。方法：回顾性分析经病理证实的45例前纵隔原发恶性肿瘤患者的影像及临床资料。结果：45例中有胸腺癌17例，病灶中央见囊变坏死，多数肿块囊变坏死区较多、较大；恶性淋巴瘤14例，呈单个不规则形软组织肿块或多个结节相互融合，并包绕大血管生长，多数肿块周围及（或）其他部位见肿大淋巴结；恶性生殖源性肿瘤12例，其中10例尿绒毛膜促性腺激素（HCG）或血甲胎球蛋白（AFP）水平异常，4例见钙化，3例见脂肪成分；恶性孤立性纤维瘤1例，位于前上纵隔偏左侧，内见囊变坏死，三期增强后呈“渐进性”强化；神经内分泌癌1例，边界清，内见囊变坏死，增强后呈环形强化。结论：前纵隔原发性恶性肿瘤的MSCT表现具有一定的特征性，结合临床特点，有助于对其行准确的诊断及疗效评估。
目的：探討前縱隔原髮性噁性腫瘤的MSCT錶現，以提高診斷水平。方法：迴顧性分析經病理證實的45例前縱隔原髮噁性腫瘤患者的影像及臨床資料。結果：45例中有胸腺癌17例，病竈中央見囊變壞死，多數腫塊囊變壞死區較多、較大；噁性淋巴瘤14例，呈單箇不規則形軟組織腫塊或多箇結節相互融閤，併包繞大血管生長，多數腫塊週圍及（或）其他部位見腫大淋巴結；噁性生殖源性腫瘤12例，其中10例尿絨毛膜促性腺激素（HCG）或血甲胎毬蛋白（AFP）水平異常，4例見鈣化，3例見脂肪成分；噁性孤立性纖維瘤1例，位于前上縱隔偏左側，內見囊變壞死，三期增彊後呈“漸進性”彊化；神經內分泌癌1例，邊界清，內見囊變壞死，增彊後呈環形彊化。結論：前縱隔原髮性噁性腫瘤的MSCT錶現具有一定的特徵性，結閤臨床特點，有助于對其行準確的診斷及療效評估。
목적：탐토전종격원발성악성종류적MSCT표현，이제고진단수평。방법：회고성분석경병리증실적45례전종격원발악성종류환자적영상급림상자료。결과：45례중유흉선암17례，병조중앙견낭변배사，다수종괴낭변배사구교다、교대；악성림파류14례，정단개불규칙형연조직종괴혹다개결절상호융합，병포요대혈관생장，다수종괴주위급（혹）기타부위견종대림파결；악성생식원성종류12례，기중10례뇨융모막촉성선격소（HCG）혹혈갑태구단백（AFP）수평이상，4례견개화，3례견지방성분；악성고립성섬유류1례，위우전상종격편좌측，내견낭변배사，삼기증강후정“점진성”강화；신경내분비암1례，변계청，내견낭변배사，증강후정배형강화。결론：전종격원발성악성종류적MSCT표현구유일정적특정성，결합림상특점，유조우대기행준학적진단급료효평고。
Objective To investigate the MSCT imaging of anterior mediastinal primary malignant tumors , and to improve the accuracy of diagnosis. Methods The imaging and clinical data of forty-five patients with anterior mediastinal primary malignant tumors were retrospectively analyzed. Results Among all forty-five cases, there were seventeen thymic carcinomas , and cystic and necrotic earas were seen in all cases. Fourteen were malignant lymphomas with a single irregular soft tissue mass or multiple merged nodules. There were enlarge lymph nodes around the tumors and (or) in other parts of the body. Twelve cases were malignant germinomas, the levels of rinary human chorionic gonadotropin (HCG) or blood armour fetuin (AFP) were abnormal in ten cases, and calcifications were seen in four cases and fat composition was observed in three cases. One malignant solitary fibrous tumor was observed on the left side of the anterior-superior mediastinum with cystic degeneration and necrosis. One was neuroendocrine carcinoma with clear boundary , cystic degeneration and necrosis , after enhanced scanning , it showed ring-shaped reinforcement. Conclusion Anterior mediastinal primary malignant tumors have certain characteristics of MSCT findings , in combination with clinical information , which can help the diagnosis and efficacy evaluation.
