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多层螺旋 CT 对直径小于 3cm 的胸内高密度胸腺囊肿与胸腺瘤的鉴别诊断价值

Multislice computed tomography performance in differential diagnosis of high-density thymic cyst and thymoma in lesions less than 3 cm.

机构信息

Department of Radiology, Ningbo No.7 Hospital, Ningbo, China.

Department of Radiology, Ningbo No.2 Hospital, Ningbo, China.

出版信息

Thorac Cancer. 2018 Oct;9(10):1300-1304. doi: 10.1111/1759-7714.12840. Epub 2018 Aug 21.

Abstract

BACKGROUND

This study was conducted to evaluate the performance of multislice computed tomography (MSCT) to diagnose high-density thymic cysts and thymomas in lesions measuring < 3 cm.

METHODS

The records of 42 patients admitted to Ningbo No. 2 Hospital with an anterior mediastinal mass (diameter < 3 cm) suspected of carcinoma originating from the thymus were retrospectively analyzed. All patients underwent surgery and pathological examination. Twenty-eight were diagnosed with thymic cysts and 14 with thymoma. The features of thymic cysts and thymomas revealed on MSCT were compared.

RESULTS

Mediastinal masses with a triangular or teardrop shape and a straight mediastina-lung border were more likely to be diagnosed as thymic cysts (P < 0.05), while those with a bulging nodule-lung border were more likely thymomas (P < 0.05). Using the CT value as a reference for differential diagnosis, the diagnostic sensitivity, specificity, and area under the receiver operating characteristic curve for CT values of non-contrast CT images, enhanced CT values, and ΔCT values were 0.65 (0.47-0.84), 0.95(0.86-1.00), and 0.96 (0.89-1.00), respectively.

CONCLUSION

MSCT of high-density thymus gland nodules (maximum diameter ≤ 3 cm) can reveal specific features that could be helpful for differential diagnosis.

摘要

背景

本研究旨在评估多层螺旋 CT(MSCT)诊断最大直径≤3cm 的高密度胸腺囊肿和胸腺瘤的性能。

方法

回顾性分析了宁波第二医院 42 例因前纵隔肿块(直径<3cm)而疑似胸腺癌的患者记录。所有患者均接受了手术和病理检查。其中 28 例诊断为胸腺囊肿,14 例诊断为胸腺瘤。对比分析 MSCT 显示的胸腺囊肿和胸腺瘤的特征。

结果

纵隔肿块呈三角形或泪滴形,纵隔-肺界面平直,更有可能被诊断为胸腺囊肿(P<0.05),而那些纵隔-肺界面呈膨出结节状的则更有可能是胸腺瘤(P<0.05)。以 CT 值为参考进行鉴别诊断,非增强 CT 图像、增强 CT 值和ΔCT 值的 CT 值的诊断灵敏度、特异性和受试者工作特征曲线下面积分别为 0.65(0.47-0.84)、0.95(0.86-1.00)和 0.96(0.89-1.00)。

结论

MSCT 对高密度胸腺结节(最大直径≤3cm)的表现具有特异性特征,有助于鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdea/6166092/e6938586f174/TCA-9-1300-g001.jpg

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