Journal of Thoracic and Cardiovascular Surgery
Journal of Thoracic and Cardiovascular Surgery
5 years ago

Anterior mediastinal tissue volume is correlated with anti-acetylcholine receptor antibody level in myasthenia gravis

Extended thymectomy is a treatment option for myasthenia gravis (MG), but the surgical indications are controversial. Pathological features of the thymus can be used to predict surgical outcomes, but there is no reliable method for evaluating these characteristics preoperatively. The purpose of this study was to determine whether anterior mediastinal tissue volume, as measured using 3DCT volumetry, correlates with serum AChRAb levels in patients undergoing thymectomy for myesthenia gravis. Therefore, we investigated the relationships among anterior mediastinal tissue volume determined by three dimension computed tomography (3DCT) volumetry, and anti-acetylcholine receptor antibody (AChRAb) levels. Methods The subjects were 28 patients who underwent extended thymectomy and were enrolled retrospectively. We measured anterior mediastinal volumes (VAM) and calculated the volumes of more than -30 Hounsfield Unit (HU) (V-30) by using 3DCT volumetory, and compared with perioperative AChRAb levels. The significance of their volumes in MG was examined by comparison with 53 non-MG patients. Results V -30 values were related to the age and significantly higher in MG patients than in non-MG patients (P < 0.001). V-30 values were correlated positively with preoperative AChRAb levels (ρ = 0.505, P = 0.006) and inversely with the post/preoperative AChRAb ratio (ρ = -0.453, P = 0.018). The histological non-adipose tissue ratio was correlated with the V-30/VAM (ρ= 0.700, P < 0.001). Conclusions This method for evaluation of the anterior mediastinal tissue volume and AChRAb production may be helpful in establishing a treatment plan for MG.

Publisher URL: www.sciencedirect.com/science

DOI: S002252231732425X

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