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目的:探讨纵隔非畸胎类生殖细胞瘤CT表现,并与前纵隔最常见恶性肿瘤胸腺癌行鉴别诊断分析。方法:回顾性分析病理证实且有完整临床及CT增强资料的纵隔非畸胎类生殖细胞瘤7例,分析各类纵隔非畸胎类生殖细胞瘤CT表现;同时比较7例非畸胎类生殖细胞瘤与11例胸腺癌临床及各项CT指标的差异,评估肿瘤强化均匀性,肿瘤内坏死灶情况,肿瘤内钙化,肿瘤形态,肿瘤分叶,肿瘤外侵及肺内及胸膜转移等情况CT表现对非畸胎类生殖细胞瘤与胸腺癌鉴别诊断的价值。结果:纵隔非畸胎类生殖细胞瘤均位于前上纵隔,影像表现为不均强化且含较大面积低密度坏死区域的实性肿块,边缘多模糊不清且形态不规则,就诊时肿瘤多较大且常压迫临近腔静脉及同侧肺门结构。本组非畸胎瘤类生殖细胞瘤与胸腺癌患者比较,发病年龄更年轻,非畸胎类生殖细胞瘤组患者肿瘤较胸腺癌组大,且肿瘤内密度相对较低,同时肿瘤内低密度坏死情况较胸腺癌明显。结论:多层螺旋CT增强扫描对于纵隔非畸胎类生殖细胞瘤诊断及与胸腺癌鉴别诊断有一定价值。
Objective: To explore the CT findings of mediastinal non-teratocarcinoma and analyze with the differential diagnosis of thymic carcinoma of the most common malignant tumor in the anterior mediastinum. Methods: Seven cases of mediastinum non-teratocarcinoma confirmed by pathology with complete clinical and CT data were retrospectively analyzed. The CT findings of various types of mediastinal non-teratocarcinoma were analyzed. Seven non-teratocarcinomas Cell tumor and 11 cases of thymic carcinoma of the clinical and CT indicators of differences in evaluation of tumor enhancement uniformity, tumor necrosis, intra-tumor calcification, tumor morphology, tumor lobulation, tumor invasion and intrapulmonary and pleural metastasis The value of CT in differentiating non-teratocarcinoma from thymus cancer. Results: The mediastinal non-teratocarcinomas were all located in the anterior superior mediastinum. The images showed heterogeneous and massive lumps of low-density necrosis. The edges were mostly blurred and irregular in shape. Larger and often oppressed near the vena cava and ipsilateral hilar structures. This group of non-teratocarcinoma germ cell tumors compared with patients with thymic cancer, the younger the onset of age, non-teratocarcinoma germ cell tumor patients than in the thymus cancer group, and the tumor density is relatively low, while the tumor low density Necrosis is more obvious than thymus. Conclusion: Multi-slice spiral CT enhanced scan has certain value for the diagnosis of mediastinal non-teratocarcinomatous germ cell tumors and differential diagnosis of thymus cancer.