胸腺瘤的影像诊断及分期课件.ppt

胸腺瘤 影像诊断及分期
胸腺瘤影像诊断及分期
病理特征
流行病学
临床特征
分期&治疗
小结
影像评价
流行病学
前纵隔最常见的原发肿瘤
发病率相对较低，占所有***恶性ka staging system
WHO type A ，Masaoka stage I
stage II in MDCT and Masaoka staging system
stage Ⅲ in MDCT and Masaoka staging system
stage Ⅲ in MDCT and Masaoka staging system
stage Ⅲ in MDCT and Masaoka staging system
stage Ⅲ in MDCT and Masaoka staging system
stage Ⅳ in MDCT and Masaoka staging system
MRI表现
T1WI低或等信号
T2WI高信号
与脂肪信号相近
MRI表现
脂肪抑制技术有助于区分肿瘤与周围脂肪
WHO type B1 thymoma in a 47-year-old woman with left-sided neck pain. (a) Axial T1-weighted MR image shows a rounded intermediate-signal-intensity mass (M) in the anterior mediastinum. (b) Axial fat-suppressed T2-weighted MR image demonstrates a 6-cm anterior mediastinal mass (M) with high signal intensity at the level of the ascending aorta (Ao). The mass was diagnosed as a lymphocyte-rich WHO type B1 thymoma at resection.
a
b
Stage III thymoma in a 52-year-old man with chest pain and dyspnea. (a) Axial double-inversion-recovery MR image demonstrates a 4-cm lobulated mass that abuts the pericardium (arrow). (b) Contrast-enhanced multiplanar double-inversion-recovery short-axis MR image demonstrates tumor invasion of the pericardium (arrow) and epicardial fat (arrowhead), findings that were confirmed at thymectomy and pericardial resection.
a
b
胸腺瘤Ⅲ期 女性，54岁，头面部肿胀，肿瘤侵犯上腔静脉，包绕右冠状动脉
MRI表现
囊变坏死
表现为长T1、长T2信号
MRI表现
瘤内纤维间隔和结节
表现为低信号，有助于囊性胸腺瘤和先天性囊肿的鉴别
Cystic thymoma in an asymptomatic 35-year-old woman. Coronal T2- weighted MR image shows an anterior mediastinal septate cystic thymoma with a septated soft-tissue nodule (arrow).
囊性胸腺瘤
MRI表现
瘤内出血信号与血肿期龄有关
含铁血黄素沉着表现为T1及T2WI上的低信号
MRI表现
肿瘤的包膜和瘤内的纤维分隔提示肿瘤侵袭性较低
PET/CT
Thymic hyperplasia in a 16-year-old boy who had undergone chemotherapy for osteosarcoma 4 months earlier. (a) Contrast-enhanced chest CT scan shows thymic enlargement. (b) PET/CT scan obtained to monitor for osteosarcoma recurrence or metastases shows diffuse FD