摘要
目的 探讨不同年龄组重症肌无力(myasthenia gravis,MG)患者胸腺MR表现并分析两者之间的相互关系。方法 根据临床症状表现确诊并正在门诊接受治疗MG患者90例进行了胸腺MR扫描,其中14/90例静脉注射Gd-DTPA增强扫描、依据胸腺发育的不同年龄阶段分为A、B、C、D4组。A组(儿童期):10岁以下33例(男18,女15);B组(青春发育期):11～25岁27例(男12,女15);C组:26～50岁17例(男6,女11);D组:51岁以上13例(男7,女6)。分析不同年龄段MG患者胸腺MR表现。对照组采用:随机检测无重症肌无力患者(Non-MG)胸部CT扫描30例,年龄8～75岁,重点观察胸腺前后径(即:厚径)、胸腺脂肪化以及胸腺萎缩变化。并以此作为正常年龄组胸腺参考因素。结果 ①胸腺区域未发现异常44/90例,占48.88％。②发现胸腺增大42/90例,占46.66％,当中,无结节性增大34例,有结节性增大8例。各组所占比例分别为:A组27/33例(81.81％),B组12/27例(44.44％),C组3例,D组未发现胸腺增大;含有结节灶的增大胸腺8例分别见于A组4例,B组3例,C组1例。③胸腺肿块4/90例(4.44％)。仅见于B组1例,C组2例,D组1例。均未发现对邻近组织侵袭信号。对照组Non-MG患者无一例胸腺增大者。此外,胸腺脂肪化可见于MG组各年龄段和对照组。结论
Objective To study MRI findings of the thymus in patients with myasthenia gravis (MG) in different age groups and to analyze the relationship between the morphological changes of thymus and the MG. Methods In total 90 patients with MG (male : female = 43 : 47) received MR scan and were divided into four groups (group A, B, C and D)by age. Fourteen patients out of 90 received additional enhanced scan. Group A included 33 patients aged under 10 years (m : f=18:15); 27 patients aged 11-25 years were in group B (m : f= 12: 15); group C had 17 patients aged 26-50 years (m : f = 6: 11 ); and in group D there were 13 patients whose ages were over 51 years (m : f =7:6). And 30 Non-MG patients aged 8-75 years were selected as control group, in which the thickness, the fat collection, and glandulous atrophy of thymus was studied on CT. Results ① The thymus was unremarkable in 44 cases out of 90 (48.88% ). ② Enlarged thymus was shown in 42 cases out of 90 (46. 66% ), in which non-nodular enlargement was revealed in 34 cases and nodular enlargement in 8 cases. There were 27 cases with abnormality of thymus out of 33 (81.81% ) in group A. 12 cases out of 27 (44. 44%) ) in group B and 3 cases in group C, but no abnormality was found in group D. ③ Only 4/90 patients (4. 44% ) had thymic mass that respectively seen in one case of group B, two of group C and one of group D. No evidence of the involvement of the adjacent structure was found on MRI in the cases of thymic mass. No thymus enlargement was revealed in control group. Fat collection in thymus was seen in both study groups and control group. Conclusion Intimate relationship between the abnormality of the thymus gland and MG exists in children and teen-agers. While in the middle-aged patients or the seniors, further studies should be made to find out whether there is a correlation.
出处
《影像诊断与介入放射学》
2003年第4期224-227,共4页
Diagnostic Imaging & Interventional Radiology
