目的 评价胸腺上皮肿瘤WHO各组织学亚型的CT特征,为术前诊断及组织学亚型预测提供依据.方法 对84例经穿刺病理或手术病理确诊为胸腺上皮肿瘤患者的病理、临床及影像学资料进行回顾性分析.A型5例、AB型22例、B1型10例、B2型11例、B3型12例、C型24例.结果 胸腺癌未出现重症肌无力.胸痛更常见于胸腺癌(50.0％).C型胸腺瘤较A型长径更大;A、AB型较B2、B3、C型更可能表现为类圆形的形状(P=0.013,0.010,0.013;0.040,0.030,0.034);C型胸腺瘤较A、AB、B1型胸腺瘤的MCI更可能呈灌铸式生长(P=0.0001,0.011,0.001),B2、B3、C型较A型的MCI更可能呈灌铸式生长(P =0.009,0.012,0.0001);C型比A、AB、B1型的MCI更易增厚呈尖角或锯齿征(P =0.036,0.0001,0.005);瘤内坏死灶显著的少见于B1型较A、AB、B2、B3、C型(P=0.017,0.011,0.001,0.010,0.0001);C型较AB、B1型更易侵犯大血管(P =0.016,0.041);B2型较AB、B1型更易出现胸膜或心包结节(P =0.002,0.023),B3型较AB型更易出现胸膜或心包结节(P =0.037);C型较AB型更易出现胸膜或心包积液(P =0.038);C型较AB、B1、B2型更可能发生纵隔淋巴结转移(P =0.005,0.034,0.019).结论 胸腺癌多以胸痛为主要症状,极少出现重症肌无力.CT征象出现率在WHO组织学各亚型之间存在一些差异,为认识各

作者：国小钰；肖湘生；于红

来源：临床放射学杂志 2013 年 32卷 11期