爱科学 › hyc3140 › 笔记

hyc3140

https://bbs.iikx.com/?4

基于T2和扩散加权磁共振成像的胶原纤维模式区分胸腺瘤、胸腺癌及淋巴瘤

已有 172 次阅读2025-3-11 17:59 |个人分类:TET学习|系统分类:医学科学| 胸腺瘤

1. 研究背景与目的

研究背景：胸腺肿瘤（如胸腺瘤、胸腺癌和淋巴瘤）内部的胶原纤维数量和分布不同，这些差异可以通过T2加权和弥散加权磁共振成像（MRI）清晰检测。
研究目的：探讨胸腺瘤、胸腺鳞状细胞癌（TSCCs）、其他胸腺癌（OTC&NTs）和胸腺淋巴瘤在影像学上的胶原纤维模式（CFPs），并评估CFPs在胸腺肿瘤鉴别诊断中的有效性和可重复性。

2. 材料与方法

样本选择：回顾性分析398例经病理确诊的胸腺瘤、胸腺癌和淋巴瘤患者的T2加权和弥散加权MRI图像。
分类标准：将CFPs分为四类：间隔征象（septum sign）、斑片状模式（patchy pattern）、混合模式（mixed pattern）和无间隔征象（no septum sign）。
数据分析：比较不同胸腺肿瘤中CFPs的发生率，并分析其在鉴别诊断中的有效性和可重复性。

3. 结果

显著差异：胸腺瘤、胸腺鳞状细胞癌、其他胸腺癌和神经内分泌肿瘤（OTC&NTs）以及胸腺淋巴瘤之间的CFPs存在显著差异。
具体表现：
- 间隔征象：出现在86%的胸腺瘤中，显著区别于其他胸腺肿瘤（p < 0.005）。
- 斑片状模式：主要见于胸腺鳞状细胞癌（80.3%）。
- 混合模式：主要见于其他胸腺癌和神经内分泌肿瘤（78.9%）。
- 无间隔征象：主要见于胸腺淋巴瘤（56.9%）。
一致性：两位观察者对CFPs的评价具有良好的一致性。

4. 结论

结论：基于T2加权和弥散加权MRI的CFPs在胸腺肿瘤的鉴别诊断中具有重要价值，尤其是在区分胸腺瘤、胸腺鳞状细胞癌和其他胸腺癌及淋巴瘤方面表现出高效性和可重复性。

5. 关键点总结

不同肿瘤间的差异：胸腺瘤、胸腺鳞状细胞癌、其他胸腺癌和神经内分泌肿瘤以及胸腺淋巴瘤在CFPs上存在显著差异。
具体模式分布：间隔征象主要见于胸腺瘤（86%），斑片状模式见于胸腺鳞状细胞癌（80.3%），混合模式见于其他胸腺癌和神经内分泌肿瘤（79%），无间隔征象见于胸腺淋巴瘤（57%）。
诊断效能：CFPs在鉴别胸腺瘤、胸腺鳞状细胞癌和胸腺淋巴瘤方面具有高有效性和可重复性。
参考来源：Hu, Yu-Chuan et al. Differentiating thymoma, thymic carcinoma and lymphoma based on collagen fibre patterns with T2- and diffusion-weighted magnetic resonance imaging. European radiology. 2022 Jan;32(1):194-204.

Objectives: The amount and distribution of intratumoural collagen fibre vary among different thymic tumours, which can be clearly detected with T2- and diffusion-weighted MR images. To explore the incidences of collagen fibre patterns (CFPs) among thymomas, thymic carcinomas and lymphomas on imaging, and to evaluate the efficacy and reproducibility of CFPs in differential diagnosis of thymic tumours.

Materials and methods: Three hundred and ninety-eight patients with pathologically diagnosed thymoma, thymic carcinoma and lymphoma who underwent T2- and diffusion-weighted MR imaging were retrospectively enrolled. CFPs were classified into four categories: septum sign, patchy pattern, mixed pattern and no septum sign. The incidences of CFPs were compared among different thymic tumours, and the efficacy and reproducibility in differentiating the defined tumour types were analysed.

Results: There were significant differences in CFPs among thymomas, thymic squamous cell carcinomas (TSCCs), other thymic carcinomas and neuroendocrine tumours (OTC&NTs) and thymic lymphomas. Septum signs were found in 209 (86%) thymomas, which differed between thymomas and any other thymic neoplasms (all p < 0.005). The patchy, mixed patterns and no septum sign were mainly seen in TSCCs (80.3%), OTC&NTs (78.9%) and thymic lymphomas (56.9%), respectively. The consistency of different CFP evaluation between two readers was either good or excellent. CFPs achieved high efficacy in identifying the thymic tumours.

Conclusion: The CFPs based on T2- and diffusion-weighted MR imaging were of great value in the differential diagnosis of thymic tumours.

Key points: • Significant differences are found in intratumoural collagen fibre patterns among thymomas, thymic squamous cell carcinomas, other thymic carcinomas and neuroendocrine tumours and thymic lymphomas. • The septum sign, patchy pattern, mixed pattern and no septum sign are mainly seen in thymomas (86%), thymic squamous cell carcinomas (80.3%), other thymic carcinomas and neuroendocrine tumours (79%) and thymic lymphomas (57%), respectively. • The collagen fibre patterns have high efficacy and reproducibility in differentiating thymomas, thymic squamous cell carcinomas and thymic lymphomas.

Keywords: Lymphoma; Magnetic resonance imaging; Squamous cell carcinoma; Thymoma; Thymus neoplasms.