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[胸腺疾病诊断方法的比较评估]

[Comparative evaluation of diagnostic methods in thymus disease].

作者信息

Kuzin M I, Shkrob O S, Vetshev P S, Belichenko O I, Sinitsyn V E, Kuznetsov N S, Ippolitov I Kh, Voronov L I, Iagelśkiĭ V P

出版信息

Khirurgiia (Mosk). 1993 May(5):3-9.

PMID:8089983
Abstract

From analysis of the case records of 2,000 patients with the generalized form of myasthenia, who underwent operation at the surgical faculty clinic of the Moscow Medical Academy, the authors discuss in detail the results of using a wide spectrum of methods for examination of the thymus, including: pneumomediastinography (PMG), scintigraphy, phlebography, computed and magnetoresonance tomography (CT and MRT). Taking into account the sensitivity and specificity of each of these methods, the indications and contraindications, and the degree of invasiveness, the authors concluded that MR tomography is the method of choice for examination of the thymus. It yields the rechest information and is most simple and safe for the patient. They also noted that CT made it possible to locate the pathological process more exactly, and provided additional information on the degree of the invasion, the presence of implants, and the condition of the other mediastinal organs. The indications for phlebography of the thymus and PMG are limited because of their invasiveness, difficult techniques, high risk of complications, and relatively low informativeness. Scintigraphy of the thymus is the least informative examination method. In view of the high percentage of pseudopositive and pseudonegative results, it may be concluded that its use for detecting lesions of the thymus in patients with myasthenia is hardly expedient.

摘要

通过对在莫斯科医学院外科临床接受手术的2000例全身型重症肌无力患者病例记录的分析,作者详细讨论了使用多种胸腺检查方法的结果,包括:纵隔充气造影(PMG)、闪烁扫描、静脉造影、计算机断层扫描和磁共振断层扫描(CT和MRT)。考虑到每种方法的敏感性和特异性、适应证和禁忌证以及侵入性程度,作者得出结论,磁共振断层扫描是胸腺检查的首选方法。它能提供最详细的信息,对患者来说最简单且最安全。他们还指出,CT能够更准确地定位病变过程,并提供有关侵犯程度、种植体存在情况以及其他纵隔器官状况的额外信息。胸腺静脉造影和PMG的适应证有限,因为它们具有侵入性、技术难度大、并发症风险高且信息相对较少。胸腺闪烁扫描是信息最少的检查方法。鉴于假阳性和假阴性结果的比例很高,可以得出结论,将其用于检测重症肌无力患者的胸腺病变不太合适。

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