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[磁共振成像在胸腺肿瘤诊断中的应用研究——影像学与病理学相关性]

[A study of the utility of the MR image for the diagnosis of thymic tumors--imaging and pathologic correlation].

作者信息

Endo M, Adachi S, Kusumoto M, Itouji E, Sakai E, Meno S, Kono M, Obayashi C, Takada Y

机构信息

Department of Radiology, Kobe University School of Medicine.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1993 Jan 25;53(1):1-10.

PMID:8441592
Abstract

MR imaging was performed in 25 patients with thymic tumors (five with non-invasive thymomas, 15 with invasive thymomas, and five with thymic carcinomas), and the MR imaging appearance was compared with the pathological findings. Non-invasive thymomas showed generally oval or round masses with well-defined margins and homogeneous intensity on T1- and T2-weighted images. Invasive thymomas showed a multinodular appearance in 79% (11/15) of cases, and an internodular difference in signal intensity (IDSI) in 64% (7/11) on T2-weighted images. It was considered that the IDSI on T2-weighted images correlated pathologically with the hemorrhagic and/or necrotic areas and hyalinization. The IDSI seemed to be a characteristic finding of invasive thymomas. The histological findings and MR imaging appearance of thymomas were compared. The predominantly epithelial type showed a low incidence of nodular appearance but showed marked IDSI on T2-weighted images. Therefore, it is more likely that the predominantly epithelial type induced more varied intratumoral changes than other types. Extension of thymic carcinomas was similar to that of invasive thymomas on MR imaging, but thymic carcinomas showed no definite nodular appearance. In conclusion, MR images in thymic tumors were useful for not only determining the morphology of the tumor but also the tissue characteristics. Therefore, MR imaging can be a useful modality to correlate with the histological findings and biological behavior of thymic tumors.

摘要

对25例胸腺肿瘤患者(5例非侵袭性胸腺瘤、15例侵袭性胸腺瘤和5例胸腺癌)进行了磁共振成像(MR成像)检查,并将MR成像表现与病理结果进行了比较。非侵袭性胸腺瘤在T1加权像和T2加权像上通常表现为椭圆形或圆形肿块,边界清晰,信号均匀。侵袭性胸腺瘤在79%(11/15)的病例中表现为多结节状,在T2加权像上64%(7/11)存在结节间信号强度差异(IDSI)。认为T2加权像上的IDSI在病理上与出血和/或坏死区域及玻璃样变相关。IDSI似乎是侵袭性胸腺瘤的一个特征性表现。比较了胸腺瘤的组织学表现和MR成像表现。以上皮细胞为主型表现为结节状的发生率较低,但在T2加权像上有明显的IDSI。因此,以上皮细胞为主型比其他类型更易引起肿瘤内更复杂的变化。胸腺癌在MR成像上的扩展与侵袭性胸腺瘤相似,但胸腺癌无明确的结节状表现。总之,胸腺肿瘤的MR图像不仅有助于确定肿瘤的形态,还能确定组织特征。因此,MR成像可作为一种有用的检查方法,用于与胸腺肿瘤的组织学表现和生物学行为相关联。

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