目的探讨CT平扫与增强扫描对 纵膈畸胎瘤的诊断价值。方法 选取我院 2014年1月-2016年12月收治的纵膈畸胎瘤 患者53例，收集53例患者的临床资料、 影像学资料等，分析53例纵膈畸胎瘤患 者CT平扫及CT增强扫描的图像表现，并 以病理学检查结果为标准，比较CT平扫 与CT增强扫描对纵膈畸胎瘤的检出率及 诊断准确率。结果 53例纵膈畸胎瘤患者 中，囊性畸胎瘤者22例(41.50%)，良性 实质性畸胎瘤者21例(39.62%)，恶性畸 胎瘤者10例(18.86%)；CT平扫对纵膈畸 胎瘤的总检出率及总准确诊断率分别为 75.47%(40/53)、56.60%(30/53)，CT增强 分别为100%(53/53)、96.22%(51/53)，CT 增强扫描对纵膈畸胎瘤的总检出率及总准 确诊断率明显优于CT平扫，差异具有统计 学意义(P<0.05)；囊性畸胎瘤例均为良性 病变，CT平扫瘤体外观主要呈现囊状，水 样密度，壁薄完整，边缘光滑，CT增强扫 描可见瘤体薄壁及瘤体内分隔明显强化， 瘤体内未见明显强化；良性实质性畸胎瘤 CT平扫可见瘤体包膜完整，瘤体内可见浅 分叶，CT增强扫描可见瘤体轻度不均匀强 化，瘤体实质部分为软组织密度；纵膈恶 性畸胎瘤CT平扫可见软组织密度肿块影， 外观不规则，边界与周围组织模糊不清， 瘤体内未见钙化影，CT增强扫描可见患者 肿瘤向外突破包膜侵犯邻近脏器，病变区 域呈现不均匀强化，中心未见明显强化。 结论 CT增强扫描可直观显示纵膈畸胎瘤 的图像特征，检出率及诊断准确率高，可 为临床提供可靠影像学资料。

Objective To evaluate the diagnostic value of CT scan and enhanced scan for mediastinal teratoma. Methods 53 cases of mediastinal teratoma were treated in our hospital from January 2014 to December 2016, collect the clinical data and imaging data of 53 cases, analyze the CT scan and CT enhanced scan of 53 patients with mediastinal teratoma, Pathological examination results were used as standard to compare the detection rate and diagnostic accuracy of CT scan and CT enhanced scan in mediastinal teratoma. Results The 53 patients with mediastinal teratoma, 22 were cystic teratoma (41.50%), there were 21 patients with benign parenchymal teratoma (39.62%) and 10 patients with malignant teratoma (18.86%). The total detectable rate and total accurate diagnosis rate of mediastinal teratoma by CT scan were 75.47% (40/53), 56.60% (30/53), and CT enhancement was 100% (53/53) and 96.22% (51/53), respectively, the total detection rate and total accurate diagnosis rate of mediastinal teratoma were significantly better than those of CT scan by CT enhanced scan, the difference was statistically significant (P<0.05). The cystic teratoma cases were benign lesions, and the CT scan showed cystic appearance, watery density, thin wall and smooth edge, CT enhanced scan showed that the tumor parenchyma, parenchyma and tumor were obviously strengthened, and there was no obvious enhancement in the tumor. The benign solid teratoma CT scan showed that the tumor capsule was intact, the superficial lobes were seen in the tumor, and the CT enhanced scan showed a slight inhomogeneous enhancement of the tumor. The parenchyma of the tumor was partly the density of soft tissue. CT scan of mediastinal malignant teratoma showed soft tissue density, mass image, irregular appearance, blurred boundary and surrounding tissue, there was no calcification in the tumor. CT enhanced scan revealed that the tumor broke through the envelope and invaded adjacent organs, the lesions showed inhomogeneous enhancement, with no obvious enhancement in the center. Conclusion CT enhanced scan can display the image features of mediastinum teratoma with high detection rate and high diagnostic accuracy, which can provide reliable imaging data for clinical treatment.