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Objective: thymic epithelial tumors (thymic epithelial tumor, TET) including thymoma and thymic carcinoma are starting from thymic epithelial tissue, there are a variety of histological features and biological behavior. In this study, a retrospective analysis of 65 patients with thymic epithelial tumors pathology and multi-slice spiral CT data, to investigate the correlation of CT TET invasive diagnostic value, as well as tissue typing and CT signs of TET. Materials and methods: a review of 65 cases confirmed by surgery or biopsy in our hospital from March 2005 to December 2009 TET patients with clinical and imaging data, including 38 males and 27 females, age median 42-year-old (3-75 years old). Clinical manifestations of cough, sputum (n = 9), chest tightness, chest pain (19 cases), 37 were found due to a physical examination or complications, which is the most important for myasthenia gravis (19 cases). 54 cases TET underwent surgical resection pathological findings, pathological results of 11 patients after a puncture. CT examination revealed a mediastinal tumor and surgery time interval of seven days to a month, an average of 11 days. SIMENSE Sensation 16 spiral CT machine and GE 64-slice spiral CT machine, scan range from the thoracic inlet to the diaphragm. Using 120KV SIMENSE CT machine, 200mA scan field of view (Field of view, FOV) 220 ~ 380mm, matrix 512 × 512, slice thickness, layer distance is 5 to 10 mm; GE CT machine adopts 120KV, 300mA scans, FOV 360 ~ 360mm, matrix 512 × 512, slice thickness, layer distance are 5mm. All patients underwent unenhanced check 55 routine enhanced scan contrast agent Omnipaque 60 to 100 ml (300 mgI / ml), the injection flow rate of 2.0 to 3.0 ml / s. Workstation vascular reorganization and multi-plane reorganization (MPR). Lung window, the window width of 1500 to 1700, window level -400 to -500; mediastinal window, the window width from 300 to 350, window level of 30 to 40.3, CT images were reviewed, and record the CT signs, determine tumor aggressiveness and clinical Masaoka staging, and surgical pathology; all cases in accordance with the latest WHO histological criteria (2004) re-divided into six subtypes: A, AB, B1, B2, B3 and thymic carcinoma and simplify the three subgroups of , low-risk group (A, AB, B1), the high-risk group (B2, B3 type) and thymic carcinoma. 4, using the SPSS 13.0 software, count data correlation using rank sum test. TET various correlation analysis between the CT signs with histological type, subtype group χ2 test, when n ≥ 40 and T ≥ 5, whichever Pearson Chi-square P value; When n ≥ 40 and a plaid ≤ 1 T lt; 5, take the the Continuity Correction P value; When n lt; 40 or T = 0, using the exact probability method. The various subtypes Leader diameter, short diameter difference LSD test using analysis of variance. The Inspection levels of α = 0.05. (N is the total number of cases, T for a single lattice number of cases) results: TET MSCT findings of 22 cases of non-invasive thymoma, tumor edge showed smooth performance, the mediastinal fat layer were clearly the 14 exceptions shaped showed class round, uniform density, enhanced scan lesions showed homogeneous enhancement; 34 cases of invasive thymoma, showed the gap disappears for normal fat mass and lung irregular contact surface the 21 exceptions shaped lobulated edge is not sharp, 14 See cystic necrosis in patients with lesions, 12 lesions calcification; 9 cases of breast cancer, tumors lobulated or irregular shape, edge is not smooth 7 lesions, 8 lesions cystic necrosis, six cases prompted pleural invasion, five cases of mediastinal lymph node or distant metastasis, eight cases of heterogeneous enhancement. 2, 36 cases of invasive tumors of the MSCT and Pathology of invasive TET CT showed anterior mediastinal soft tissue mass, incomplete tumor capsule 24 cases, pleural invasion 14 cases, the pericardial invasion nine cases, nine cases of vascular invasion . A total of 96 lesions can control the results of 86 true-positive, seven false positives, 0 true negative, three false-negative, and accuracy of 89.6% (86/96). TET MSCT staging and pathological staging control 54 cases TET MSCT determine tumor stage and pathological staging contrast, MSCT diagnostic accuracy of four installments, respectively, 83.3% (15/18), 76.5% ( 13/17), 90.9% (10/11), 100.0% (8/8), the overall accuracy of 85.2% (46/54). 4, TET tissue typing with pathology correlation by pathology diagnosed 54 cases TET four cases of type A, AB 6 cases, B 1 -type 12 cases, B < / sub>-type 14 cases, 12 cases of B 3 -type, six cases of thymic carcinoma. Masaoka pathological stage Ⅰ 18 cases, Ⅱ 17 cases, Ⅲ of 11 cases, Ⅳ of eight cases. Histological type and Masaoka staging compared, both with significant correlation (γs = 0.597, P = 0.000). 65 cases related TET TET of MSCT signs and histological type, low-risk group, 25 cases, 31 cases of the high-risk group, 9 cases of thymic carcinoma group. The lumps smooth edges, more uniform density, the mediastinal fat layer is clear, homogeneous enhancement CT signs prompted for the low-risk group (A, AB, B1), and CT signs of irregular shape, necrotic or cystic lesions, mediastinal fat layer blur or disappear, pleural or vascular structures violations of lymph node or distant metastasis, the heterogeneous enhancement prompt thymic carcinoma. Between the high-risk group (B2, B3 type) with the low-risk group, there is some overlap between the CT signs in the high-risk group of thymic carcinoma group. Conclusion: MSCT TET higher diagnostic value and of guiding clinical significance; accurate CT display of aggressive tumors preoperative staging and extent of disease and to provide accurate information on the clinical staging and treatment plan; WHO histological pathological Masaoka staging there is a correlation, both can provide important information for prognosis; lumps smooth edges, more uniform density, mediastinal fat layer is clear, homogeneous enhancement CT signs suggestive of the low-risk group (A, AB , B1-type), and CT signs of irregular shape, necrotic or cystic lesions, mediastinal fat layer fuzzy or disappear, the pleura or vascular structure infringement, lymph nodes or distant metastasis the heterogeneous enhancement prompt thymic carcinoma; high-risk group between the low-risk group, the high-risk group of thymic carcinoma group between CT signs there is some overlap, identification is difficult.
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