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[影像医学] 原发性恶性胸腺生殖细胞肿瘤22例CT和MRI表现

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发表于 2023-3-28 16:46:15 | 显示全部楼层 |阅读模式
本帖最后由 hyc3140 于 2023-3-28 16:48 编辑

CT and MRI features in 22 cases of primary malignant thymic germ cell tumours
目的:分析恶性胸腺生殖细胞肿瘤(GCT)的计算机断层扫描(CT)和磁共振成像(MRI)特征,以提高恶性胸腺生殖细胞肿瘤的诊断准确性。Aim: To analyse the computed tomography (CT) and magnetic resonance imaging (MRI) features of malignant thymic germ cell tumours (GCTs), in order to improve the accuracy of diagnosis of these tumours.
材料与方法:22例患者(男20例,女2例;年龄(28±8.64岁),经组织病理证实为恶性胸腺GCT的患者,回顾性分析其CT和MRI表现。
Materials and methods: Twenty-two patients (20 men, two women; age, 28 ± 8.64 years) with malignant thymic GCTs confirmed at histopathology were enrolled retrospectively, and their CT and MRI findings were analysed.
结果:CT表现为胸腺恶性GCT多表现为较大肿块,多向中线两侧生长(20/ 22,90.9%),形状不规则(15/ 22,68.2%),分叶状(12/ 22,50%),边缘不清(9/ 22,40.9%),包膜不完整(21/ 22,95.5%)。20例肿块密度不均,19例(86.4%)为多灶性坏死或囊变。大部分病例(16/18,88.9%)表现为轻度至中度强化,14例(14/18,77.8%)发现分支样血管。14例患者最小表观扩散系数(ADCmin)和平均表观扩散系数(ADCmean)分别为(1.13±0.45)和(1.37±0.49)× 10-3 mm2/s。与CT表现相比,所有恶性胸腺GCT患者MRI上均出现包膜不完整、信号不均匀、坏死或囊性改变。14例(100%)肿瘤周围均有水肿
Results: According to the CT findings, malignant thymic GCTs usually manifest as a bulky mass that typically grows to both sides of the midline (20/22, 90.9%), with irregular shape (15/22, 68.2%), lobulation (12/22, 50%), ill-defined margin (9/22, 40.9%), and incomplete capsule (21/22, 95.5%). Twenty masses revealed heterogeneous density with multifocal necrosis or cystic change in 19 (86.4%). Most cases (16/18, 88.9%) showed mild to moderate enhancement, and the branch-like vessel was found in 14 (14/18, 77.8%) cases. The minimum apparent diffusion coefficient (ADCmin) and mean apparent diffusion coefficient (ADCmean) values in 14 patients were (1.13 ± 0.45) and (1.37 ± 0.49) × 10-3 mm2/s, respectively. Compared with CT findings, the incidences of an incomplete capsule, heterogeneous signal, and necrotic or cystic change on MRI images occurred in all patients with malignant thymic GCT. In addition, peritumoural oedema was found in all 14 (100%) cases.
结论:MRI在显示GCT包膜不完整、瘤周水肿、信号不均匀、坏死或囊性改变方面优于CT。分枝样强化和多灶性坏死有助于恶性胸腺 GCT的诊断。
Conclusion: MRI is superior to CT in showing incomplete capsule, peritumoural oedema, heterogeneous signal, and necrotic or cystic change of GCTs. Branch-like enhancement and multifocal necrosis may help the diagnosis of malignant thymic GCTs.
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引用文献:Hu YC, Wang SZ, Xiao G, Liu CX, Wang SM, Kou HL, Cui GB. CT and MRI features in 22 cases of primary malignant thymic germ cell tumours. Clin Radiol. 2022 May;77(5):390-398. doi: 10.1016/j.crad.2022.01.047. Epub 2022 Feb 12. PMID: 35164927.




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