【摘要】 目的 探讨胸腺高密度囊肿的CT征象，以提高临床诊断的准确率。方法 选取经手术病理证实为胸腺囊肿且CT平扫表现为高密度结节（CT值≥20 HU）的58例患者的临床及影像学资料进行分析。根据增强扫描后影像学诊断是否正确，将58例患者分为诊断正确组（n=21）和诊断错误组（n=37），并对其常规临床特征及病灶的大小、形态、边缘与纵隔胸膜的关系、平扫CT值、增强扫描动脉期及静脉期强化幅度（?CT值）进行归纳整理。采用PEMS 3.2统计软件分析两组数据，以P<0.05为差异有统计学意义，并使用多因素Logistic回归分析寻找行增强扫描的胸腺高密度囊肿的误诊因素。结果 58例患者诊断准确率为36.21%(21/58)，其中有强化现象的23例诊断准确率为17.39%(4/23)。单因素分析显示两组病灶除最小径、动脉期?CT值差异有统计学意义（P<0.05）外，其余临床特征及CT征象比较，差异均无统计学意义（P>0.05），多因素Logistic回归分析显示动脉期?CT值是误诊的独立预测因素。结论 CT增强扫描对于胸腺高密度囊肿有一定的鉴别诊断价值，但对有强化现象的胸腺高密度囊肿的诊断仍存在一定缺陷，存在误诊的风险。更多还原

【Abstract】 Objective To investigate the CT imaging features of high density thymic cysts in order to improve the accuracy of clinical diagnosis. Methods A retrospective analysis was conducted on the clinical and imaging data of 58 patients with thymic cysts confirmed by surgical pathology, all of whom presented with high density nodules(CT value ≥20 HU) on non-contrast CT scans. Based on the accuracy of the diagnosis after contrast-enhanced CT scans, the 58 patients were divided into a correct diagnosis group(n=21) and a misdiagnosis group(n=37). The clinical characteristics and imaging features of the lesions, including size, shape, margin, relationship with the mediastinal pleura, non-contrast CT value, and enhancement amplitude （?CT value） during the arterial and venous phases, were summarized. Statistical analysis was performed using PEMS 3.2 software, with P<0.05 considered statistically significant. Multivariate logistic regression analysis was used to identify factors associated with misdiagnosis of high density thymic cysts on contrast-enhanced CT scans. Results The diagnostic accuracy rate for the 58 cases was 36.21%(21/58). Among the 23 cases with enhancement phenomena, the diagnostic accuracy rate was 17.39%(4/23). Univariate analysis showed that, apart from the minimum diameter and the ?CT value in the arterial phase, which were statistically significant(P<0.05), other clinical characteristics and CT imaging features showed no statistical significance(P>0.05). Multivariate logistic regression analysis revealed that the ?CT value in the arterial phase was an independent predictor of misdiagnosis.Conclusion Contrast-enhanced CT scans have certain diagnostic value for high density thymic cysts, but there are still limitations in diagnosing high density thymic cysts with enhancement phenomena, thereby posing a risk of misdiagnosis.更多还原