【摘要】 目的:回顾性分析27例纵膈肿瘤的超声特征、临床表现及手术病理特点,探讨超声在发现纵膈肿瘤中的应用价值,协助临床评估与决策。方法:收集2017年1月至2020年5月,于我院行超声心动图检查发现的纵膈肿瘤患者27例,回顾分析其超声结果、临床资料,并与术中大体及术后病理相对照。结果:27例纵膈肿瘤,男性19例,女性8例,年龄12～74岁,中位年龄42岁。(2)病理分型:27例纵膈肿瘤中,良性肿瘤6例(22.2%),恶性肿瘤16例(59.3%),生殖细胞肿瘤5例(18.5%)。良性肿瘤包括心包囊肿2例,胸腺瘤2例,支气管囊肿1例,海绵状血管瘤1例。恶性肿瘤包括纵膈型肺癌8例,淋巴瘤5例,间叶组织恶性肿瘤2例,侵袭性胸腺瘤1例。生殖细胞肿瘤包括畸胎瘤5例,卵黄囊瘤1例。(3)纵膈肿瘤易累及的心血管部位:肺动脉最常见(10例),其次是心脏房室腔(6例),B细胞源性淋巴瘤易向上侵及主动脉弓及分支或上腔静脉,纵膈型肺癌易向下侵及下腔静脉或肺动脉。结论:超声对于纵膈肿瘤诊断的敏感性低,但是纵膈畸胎瘤、B细胞源性淋巴瘤、纵膈型肺癌具有特异性超声表现。从而,超声作为初步筛查手段对于纵膈肿瘤做出初步诊断。并且,超声可以评估肿瘤对周围器官特别是心脏的侵犯情况,为临床进一步的诊断及治疗提供重要信息。更多还原

【Abstract】 Objective: To review the current clinical experiences and pathological characteristics of differential diagnosis of mediastinum tumors. Methods: A totally 27 patients with mediastinum tumors, which were comfired by pathology, were retroepectively reviewed. The clinical and ultrasonographic characteristic were analyzed. The ultrasonographic performance were compared with operative and pathological result. Results: Of the 27 patients with mediastinum tumors, 19 were males, and 8 females. Median age was 42 years old(range 12-74 years old).(2)Pathological result included 6(22.2%)benign, 16(59.3%) malignant, 5(18.5%)germ cell tumor. Benign tumors included 2 pericardial cyst, 2 thymoma, 1 bronchial cyst, 1 cavernous hemangipma. Maligant tumors included 8 mediastinal lung cancer, 5 lymphoma, 2 mesenchymal malignant tumor, 1 invasive thymoma. Germ cell tumor included 5 teratoma, 1 yolk sac tumor.(3)The pulmonary artery(n=10) was most vulnerable, followed by the atrium or ventricle(n=6). B-cell derived lymphomas were tend to invade upwards and to the aortic arch and branches or superior vena cava, while mediastinal lung cancer easily invaded downward to the inferior vena cava or pulmonary artery. Conclusions: Ultrasonography has low sensitivity for the diagnosis of mediastinum tumor, but mediastinal teratoma, b-cell-derived lymphoma, and mediastinal lung cancer have specific ultrasound characteristic. Ultrasound can be used as a preliminary screening method and observe the invasion situation to the heart.更多还原