Multislice computed tomography performance in differential diagnosis of high-density thymic cyst and thymoma in lesions less than 3 cm.

BACKGROUND: This study was conducted to evaluate the performance of multislice computed tomography (MSCT) to diagnose high-density thymic cysts and thymomas in lesions measuring < 3 cm. METHODS: The records of 42 patients admitted to Ningbo No. 2 Hospital with an anterior mediastinal mass (diameter < 3 cm) suspected of carcinoma originating from the thymus were retrospectively analyzed. All patients underwent surgery and pathological examination. Twenty-eight were diagnosed with thymic cysts and 14 with thymoma. The features of thymic cysts and thymomas revealed on MSCT were compared. RESULTS: Mediastinal masses with a triangular or teardrop shape and a straight mediastina-lung border were more likely to be diagnosed as thymic cysts (P < 0.05), while those with a bulging nodule-lung border were more likely thymomas (P < 0.05). Using the CT value as a reference for differential diagnosis, the diagnostic sensitivity, specificity, and area under the receiver operating characteristic curve for CT values of non-contrast CT images, enhanced CT values, and ΔCT values were 0.65 (0.47-0.84), 0.95(0.86-1.00), and 0.96 (0.89-1.00), respectively. CONCLUSION: MSCT of high-density thymus gland nodules (maximum diameter ≤ 3 cm) can reveal specific features that could be helpful for differential diagnosis.

Diagnostic value of MSCT in cystic lung cancer with ground glass opacity / 实用放射学杂志

Objective To study the diagnostic value of MSCT in cystic lung cancer with ground glass opacity(GGO),and improve understanding of the disease as well as diagnostic accuracy.Methods 2 1 cases of pathologically confirmed cystic lung cancer with GGO were analyzed retrospectively,all patients were examined by MSCT.CT features of the GGO and the cysts,including bronchovascular convergence sign,speculation sign,pleural indentation sign,lobulation,thickness and uniformity of the cyst wall,septa and the location of the lesion were analyzed.Results The image findings of the 21 cases of the cystic lung cancer with GGO included:bronchovasular convergence sign in 6 cases(28.6%),speculation sign in 10 cases(47.7%),pleural indentation sign in 12 cases(57.1%),lobulation in 8 cases(38.1%),10 cases(47.7%)showed pure GGO.The cyst wall was(1.7±0.9)mm in thickness and the cyst was (13.2±7.0)mm in diameter.Cyst wall was uniform in 9 cases(42.9%),septa was seen in 14 cases(66.7%),cysts of 16 cases(76.1%)were located in the upper lobes of the lung,1 case(4.7%)had distinctly mediastinal lymph node metastasis.Air-fluid lever,mural nodule or intrapulmonary metastasis were not present in any of the cases.Conclusion The majority of the cystic lung cancer with GGO are adenocarcinoma.In addition of the interference of its prominent cystic features on MSCT,the cystic lung cancer have characteristics of lung cancer with GGO.By analyzing its CT features,diagnostic accuracy can be improved before operation.

The value of MSCT in differentiating low-or high-risk thymomas and thymic carcinomas with maximum diameter equal or less than 3 cm / 实用放射学杂志

Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.

The value of MSCT in differentiating low-or high-risk thymomas and thymic carcinomas with maximum diameter equal or less than 3 cm / 实用放射学杂志

Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.

MR Imaging Diagnosis of the tumors in the Region of Jugular Foramen / 实用放射学杂志

Objective To study the manifestations of MR of the tumor in jugular foramen area(JFA) and its diagnostic values.Methods 13 cases of tumors confirmed by pathology in JFA were reported,and the characteristics of MR of different kinds of tumor were analysed.Results There were its own MRI manifestations of different tumors in JFA,and the localizing and qualitative diagnosis of these tumors can be accurately made by MRI.Conclusion MRI is of very important diagnostic values in detecting the tumors in JFA.

Atlantoaxial Occult Fracture:Multi-slice Spiral CT Diagnosis / 实用放射学杂志

Objective To discuss the diagnostic value of multi-slice spiral CT 2D and 3D reconstruction for atlantoaxial occult fracture.Methods Multi-slice spiral CT scans were performed in 38 patients who were suspected of fracture but were not detected with radiography,and the images were post-processed with Vitrea workstation(including MPR,MIP,VR and SSD).The images were observed by two experienced radiologists.Results Of 38 cases,28 cases were detected having small fractures with spiral CT reconstruction.Conclusion Multi-slice spiral CT 2D and 3D reconstructions are of important value in diagnosing atlantoaxial occult fracture.