目的 探讨前纵隔胸腺上皮性肿瘤与淋巴瘤的磁共振成像(MRI)影像特点，分析其在两者鉴别诊断中可能的价值。方法 选择复旦大学附属中山医院厦门医院2018年1月~2023年4月期间收治的初步诊断为前纵隔胸腺瘤或淋巴瘤患者50例为受试对象，入院后均接受MRI检查，对50例患者病理结果、MRI检查诊断效能、MRI检查定性结果、胸腺瘤与淋巴瘤胶原纤维影像特征（CFP）发生率等多项指标进行评价分析。结果本组50例患者病理组织学检查提示胸腺瘤38例，淋巴瘤12例，在前纵隔胸腺瘤与淋巴瘤诊断中的符合率为86.00％，在胸腺瘤诊断方面的特异性为58.33％，灵敏性为94.73％。胸腺瘤与淋巴瘤患者分隔、瘢痕及肿大淋巴结占比存在显著差异，胸腺瘤分隔、瘢痕占比高于淋巴瘤，肿大淋巴结占比低于淋巴瘤，差异有统计学意义（P<0.05），其余钙化、囊变坏死、脏器侵犯及胸腔积液等特征对比差异无显著性（P>0.05）。胸腺瘤患者分隔征、斑片状、混合型等CFP发生率高于淋巴瘤，无分隔征的CFP发生率低于淋巴瘤，差异有统计学意义（P<0.05）。结论前纵隔胸腺瘤与淋巴瘤的MRI检查中分隔、瘢痕、肿大淋巴结、CFP发生率等差异显著，可以为疾病鉴别提供有力依据，MRI在这两种病变鉴别诊断方面的诊断符合率、特异性、灵敏性等均较高。

ObjectiveTo conduct a comprehensive investigation and analysis of the magnetic resonance imaging（MRI）characteristics of anterior mediastinal thymic epithelial tumors and lymphomas, and to assess their significance in the differential diagnosis between the two. MethodsFifty patients who were initially diagnosed with anterior mediastinal thymoma or lymphoma and were admitted to Xiamen Hospital affiliated with Zhongshan Hospital of Fudan University from January 2018 to April 2023 were selected as the research subjects. Upon admission, all patients underwent MRI examinations. The pathological findings, diagnostic efficacy of MRI examinations, qualitative outcomes of MRI examinations, and the incidence of collagen fiber pattern (CFP) in thymoma and lymphoma were evaluated and analyzed in this group of 50 patients. ResultsPathological examinations of the 50 patients in this group revealed 38 cases of thymoma and 12 cases of lymphoma. The concordance rate between the diagnosis of anterior mediastinal thymoma and lymphoma was 86.00%. The specificity in thymoma diagnosis was 58.33%, and the sensitivity was 94.73%. There were significant differences in the proportions of septa, scars, and enlarged lymph nodes between thymoma and lymphoma. The proportions of septa and scars in thymoma were higher than those in lymphoma, while the proportion of enlarged lymph nodes was lower than that in lymphoma, with statistical significance (P<0.05). There were no statistically significant differences in the comparison of other characteristics such as calcification, cystic necrosis, organ invasion, and pleural effusion (P>0.05). The incidence of CFP in thymoma patients with septa, patchy, and mixed types was higher than that in lymphoma, while the incidence of CFP in patients without septa was lower than that in lymphoma, and the difference was statistically significant (P<0.05). ConclusionThere are significant differences in the incidences of septa, scars, enlarged lymph nodes, and CFP between anterior mediastinal thymoma and lymphoma on MRI, which can offer robust evidence for disease differentiation. MRI exhibits high diagnostic accuracy, specificity, and sensitivity in the differential diagnosis of these two types of lesions.