目的：總結胸腺類癌的臨床表現、病理特征、CT表現及其臨床價值。方法：對本院收治的2例胸腺類癌進行分析并結合文獻復習。結果：胸腺類癌發病率低，大部分早期患者無臨床癥狀，經胸部X線、CT檢查時發現；中晚期始出現癥狀。病理檢查出類癌后，電鏡可見神經內分泌顆粒，免疫組化顯示神經特異性烯醇化酶、腫瘤嗜鉻蛋白A、促皮質素陽性。胸部CT表現特征為起于前上縱隔腫塊，常位于心底部大血管和心包周圍，腫塊內密度不均，可見鈣化，增強后輕中度強化，易發生胸內外轉移。結論：胸腺類癌是一罕見的前縱隔腫瘤，根據CT特征，結合臨床可有助診斷、指導手術、推測預后，因此CT在臨床診治中有非常重要的價值。
目的:明確脊柱骨巨細胞瘤的多層螺旋CT、MRI表現。方法:回顧性分析經病理證實的脊柱骨巨細胞瘤6例(男5例,女1例,年齡21～40歲,平均32歲)。6例CT檢查,3例有MRI檢查。結果:發生于胸椎3例,腰椎1例,骶椎2例。CT主要表現為膨脹性溶骨性破壞和較大軟組織腫塊;MRI表現T1加權成像為低等信號,T2加權成像為高低混雜信號特點,可顯示瘤內壞死、囊變、出血等。結論:脊柱骨巨細胞瘤具有侵襲性強、生長活躍、易復發等特點,結合CT、MRI檢查可對該病做出及時診斷,且對臨床分期、手術方案制訂及術后定期隨訪有重要價值。
Objective To clarify the thin-layer 16-slice spiral CT features of coal worker’s pneumoconiosis and the superior distribution of comorbidities in their staging and lobes and lung field anatomy. Methods Sixty-six patients with coal worker's pneumoconiosis diagnosed by the pneumoconiosis diagnosis and identification group from October 2014 to March 2015 were enrolled. All patients underwent 16-slice spiral CT and thin-layer CT reconstruction with a thickness of 1.5 mm. The thin-slice CT signs and comorbidities of coal workers’ pneumoconiosis were observed, and the superior distribution of CT signs in patients at different stage and different lobes and lung field anatomy were evaluated. Results There were 16 cases of irregular small nodules in the lungs, 22 cases of large shadow fusion, 18 cases of intraocular shadow calcification, 41 cases of emphysema, 21 cases of pulmonary bullae, 21 cases of pulmonary hypertension, and 31 cases of enlarged lymph nodes in the mediastinum and calcified. The above signs were mostly distributed in stage Ⅲ pneumoconiosis (P<0.05). There were 32 cases of regular small nodules, which were mostly distributed in stage Ⅰ pneumoconiosis. In the 16 cases of irregular small nodules, the advantage was distributed in the middle and outer lobes of the double lungs. In the 22 cases of large shadow fusion, the advantage was distributed in the upper and lower lobe of the lungs. In the 16 cases of tuberculosis, the advantage was distributed in the upper lobe of the lungs. In the 21 cases of bullous bullae, the advantage was distributed in the upper lobe of the two lungs, mostly in the right upper lung. Conclusion The thin 16-slice spiral CT signs of coal worker’s pneumoconiosis can reflect the pathological changes, and have a certain correlation with the stage of pneumoconiosis, and have obvious characteristics in the anatomical distribution of lung and lung fields.