Imaging of thymus in myasthenia gravis: from thymic hyperplasia to thymic tumor.

Abstract:

:Myasthenia gravis (MG) is an autoimmune disorder often associated with thymic abnormalities. At onset, thymic lymphoid hyperplasia (TLH) and thymoma can be found in up to 65% and 15% of patients, respectively. Diagnostic imaging is crucial in this setting in order to detect the presence and type of the thymic abnormality and in the preoperative planning, when indicated. Chest radiography has a minor role due to its low accuracy. Computed tomography is the imaging modality of choice, although the differentiation between a small thymoma and TLH that appears as a focal soft-tissue mass may be not possible. Magnetic resonance imaging (MRI) is not usually employed, but it is useful in equivocal cases, especially in differentiating focal TLH from thymoma by using chemical-shift sequences for defining the proper management. In addition, diffusion-weighted (DW)-MRI can differentiate lipid-poor normal/hyperplastic thymus from thymoma and could be useful in differentiating non-advanced from advanced thymomas. Positron emission tomography (PET)-CT is not helpful in distinguishing early from advanced thymoma but can be used to differentiate thymic carcinoma from thymoma. Hereby, we discuss the imaging features of thymic abnormalities in MG, even focusing on novel aspects of chemical-shift and DW-MRI.

journal_name

Clin Radiol

journal_title

Clinical radiology

authors

Priola AM,Priola SM

doi

10.1016/j.crad.2014.01.005

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

e230-45

issue

5

eissn

0009-9260

issn

1365-229X

pii

S0009-9260(14)00028-2

journal_volume

69

pub_type

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