Department of Radiology, University of Turin, S. Luigi Gonzaga Hospital, Turin, Italy.
Radiol Med. 2010 Feb;115(1):1-21. doi: 10.1007/s11547-009-0478-3. Epub 2009 Dec 16.
Our goal was to assess the computed tomography (CT) imaging findings of thymoma and to correlate these features with Masaoka staging system and prognosis.
CT findings of thymoma were analysed in 58 patients who had undergone surgery between January 2002 and September 2007. All cases were classified according to the Masaoka staging system. The presence of various CT findings was correlated with tumour invasiveness and recurrence. In statistical analysis, a p value <0.05 was interpreted as significant.
The study found 26 noninvasive thymomas and 32 invasive thymomas. Invasive thymomas were more likely to be greater in size (p<0.01), with lobulated or irregular contours (p<0.02), a necrotic or cystic component (p<0.04), foci of calcification (p<0.05) and heterogeneous contrast enhancement (p<0.01) than were noninvasive thymomas. Disease progression developed in nine of 58 patients. Tumour recurrence and metastasis correlated with greater size (p<0.04), lobulated or irregular contours (p<0.01), complete mediastinal fat obliteration (p<0.01), great vessel invasion (p<0.01) and pleural implants (p<0.02).
CT is useful in differentiating invasive from noninvasive thymomas and plays an important role in evaluating and treating these patients for multimodal therapy with neoadjuvant approaches. Moreover, CT findings may serve as predictors of postoperative recurrence or metastasis.
本研究旨在评估胸腺瘤的 CT 影像学表现，并将这些特征与 Masaoka 分期系统和预后相关联。
对 2002 年 1 月至 2007 年 9 月期间接受手术的 58 例胸腺瘤患者的 CT 表现进行分析。所有病例均根据 Masaoka 分期系统进行分类。各种 CT 表现与肿瘤侵袭性和复发的相关性。在统计学分析中，p 值<0.05 被认为具有统计学意义。
研究发现 26 例非侵袭性胸腺瘤和 32 例侵袭性胸腺瘤。侵袭性胸腺瘤的体积更大（p<0.01），边界更不规则（p<0.02），更易出现坏死或囊性成分（p<0.04），钙化灶（p<0.05）和不均匀强化（p<0.01）。9 例 58 例患者出现疾病进展。肿瘤复发和转移与肿瘤体积更大（p<0.04），边界不规则（p<0.01），完全纵隔脂肪消失（p<0.01），大血管侵犯（p<0.01）和胸膜种植（p<0.02）相关。
CT 有助于鉴别侵袭性和非侵袭性胸腺瘤，并在评估和治疗这些患者的新辅助治疗方面发挥重要作用。此外，CT 表现可作为术后复发或转移的预测因素。
