CT在胸壁肿瘤及肿瘤样病变诊断中的应用

Application of CT examination in the chest wall tumors and tumor-like lesions

目的探讨CT检查在胸壁肿瘤及肿瘤样病变诊断中的应用价值。方法回顾性分析和总结经手术切除、穿刺活检及临床综合确诊的胸壁肿物133例的CT表现,男72例,女61例,年龄13～76岁,平均45岁,全部病例均行胸部CT平扫检查,71例加做CT增强扫描。结果按照病变的性质分为三组:(1)胸壁结核组52例;(2)软组织肿瘤组51例:包括脂肪瘤13例,神经鞘瘤5例,血管瘤3例,纤维瘤2例,表皮样囊肿3例,脂肪疝1例,原始神经外胚层瘤2例,腺泡状软组织肉瘤1例,原发性神经内分泌癌1例,软组织转移瘤20例;(3)骨组织肿瘤组30例:骨软骨瘤2例,骨纤维异常增殖症1例,软骨肉瘤1例,骨髓瘤2例,骨转移瘤24例。结论 CT,尤其是多层螺旋CT能很好地判断胸壁肿瘤及肿瘤样病变的有无、来源、部位及范围等,对肿物的良恶性、原发或继发以及组织学定性均有重要价值,是目前诊断胸壁肿物最主要的检查手段。

Objective To investigate the diagnostic value of CT in chest wall tumors and tumor-like lesions.Methods CT findings of 133 cases of chest wall masses were retrospectively reviewed,whose diagnoses were confirmed by surgery,punctured biopsy or final clinical diagnosis including 72 males,61 females(aged 13 to 76 years,mean 45 years).All patients underwent chest plain CT scan,71 plus for enhanced CT scan.Results According to the nature of disease all cases were divided into three groups:(1)chest wall tuberculosis,52 cases;(2)soft tissue tumors,51 cases including 13 lipoma,5 nerve sheath tumors,3 hemangioma,2 fibroma,3 epidermoid cysts,1 fat hernia,2 primitive neuroectodermal tumor,1 alveolar soft part sarcoma,1 primary neuroendocrine carcinoma,and 20 soft tissue metastases;(3)bone tumor,30 cases including 2 osteochondroma,1 fibrous dysplasia,1 cartilage sarcoma,and 2 myeloma,24 bone metastases.Conclusions CT,especially MSCT can be a good judge of chest wall tumors and tumor-like lesions on presence,source,location and scope of the mass,therefore is of great significance in diagnosis.It's the most important examination for chest wall masses.