Các phương pháp chẩn đoán hình ảnh u trung thất

DIENDAN Y HOC

: ^lielia^itf^rt^teahg •

Cac phifcfng phap chan doan

hinh anh u trung that

PGS.TS. Ngo Quy Chau*, ThS. NguySn Thanh Hdi*

Cac khdi u trung ttiat nguyen phat it gap, ty le chinh xac cac l(hd'i u trung tha't iihong duac bie't ro,

tuy nhien ty le ehung vao khoang 1/100.000 nguai. Cac khoi u trung tha't thudng gap bao gdm: u tuye'n

Lie, ken trung that, u thin kinh noi tiet, cac khoi u nay chie'm khoang tren 60% so'cac trudng hap u, ken

trung that. Trieu chiing lam sang u trung that chu yeu do chen ep cac cau true trung tha't. Co khoang

gin mgt nvfa so' truang hgp u trung that khong co trieu chdng, viec chin doan xac djnh khdi u trung

that thuang dua nhiSu vao cac ky thuat cha'n doan hinh anh. Cac ky thuat hien dugc su dung phd bien

bao gdm: chup X-quang, cat ldp vi tinh (CLVT) nguc co tiem thude can quang. Khi co nghi ngd khdi co

xam la'n mach mau, cd thd chi dinh chup cong hudng td hat nhan.

I. CHUP X-QUANG NGITC QUY UffC

Trung that bao gom cac tang nam giua hai

phoi. Do trung that dtrgc phu bdi cac la ctia mang

phoi, nen cac khdi u trung that nhin cluing c6 bd

nhan, trong khi dd cac khoi u phdi do khong dtrgc

phii bdi mang phdi nSn thtrdng cd bd go ghS. Cac

khoi u trung that thudng dugc phlt hien tren phim

chup X - quang ngirc khi thay hinh anh trung that'

rong, bd trung thiit c6 hinh anh bat thudng, tuy

nhiSn cung cd nhiSu trudng hgp u trung that ma

chup X - quang nguc hoan toan binh thudng.

CIc cau true binh thudng cua trung that d bSn

phai (tir trudc ra sau) bao gom: cac mach mau canh

tay dau, tTnh mach chii trSn, quai tmh mach don,

dong much chii ISn vl nhl phai. Ben trai (tir trudc

ra sau) co: cac mach mlu canh tay dau, quai dong

mach chii, than dong mach phdi vl thiit trii. TrSn

phim chup nghieng, trung that trai rpng ttr phia sau

xuong uc tdi phia trudc cac xuang sudn.

Khoang 607c cac khoi u truns that nlm d trunc

that trudc, 25% u trung that sau vl khoang 15% u

trung that giua.

1. Mgt sd diiu benh ly trong u trung that

[1][3]

Trung that rgng

Day la dau hieu thudng gap nhat, trSn X-quang phdi

thay bdng trung that rgng hon binh thudng (hinh 1).

' Khoa Ho Hap - Benh vien Bach Mai

Hinh 1. Hinh trdn dich mdng phdi trdi, xep

phdi trdi, tii goc sudn hoanh phdi (u lympho dc

tinh khong Hodgkin loai te bdo B)

6 I Y HOC LAM SANG Sd 45 (Thang 10/2009)