局限型胸膜间皮瘤的影像诊断

IMAGING DIAGNOSIS 0F LOCALIZED PLEURAL MES0THELI0MA

作者分析了经手术及病理证实的局限型胸膜间皮瘤１９例，其中良性９例，恶性８例，未定型２例。影像表现肿物多呈椭圆形、梭形或分叶状，边缘清楚锐利，贴近胸膜表面，少数瘤内有钙化或囊变。９例良性局限性纤维型胸膜间皮瘤中，５例有蒂，蒂长１～８ｃｍ，无一例有侵犯胸壁征象；８例恶性中，２例为带蒂肿物，５例伴有胸壁软组织侵犯，４例有肋骨破坏。ＣＴ评价胸膜间皮瘤的部位和范围有明显优越性。但除了胸壁软组织和肋骨侵犯提示恶性外，影像检查结果不能区别局限型胸膜间皮瘤的良、恶性。恶性胸膜间皮瘤术后容易复发，应长期随诊。

Abstract Nineteen cases of localized pleural mesothelioma(benign 9, malignant 8,unclassified2)proved bysurgery and pathology were analyzed.Imaging manifestations included large mass,elliptic or spindlein shape,often lobulated and well delineated,close to pleural surface. There were calcifications or cys-tic changes within the mass in some cases.Of the 9 benign cases,there were pedicles of 1～8cm inlength attached to the pleural surface in 5 cases.None of the benign mesotheliomas had chest wall in-vasion or rib destruction.Of the 8 malignant mesothelioma 2 were peduncalated,5 had invaded chestwall with underlying rib destruction in 4 CT has obvious advantages for the evaluation of the locationand extenst of mesothelioma.Apart from invasion of the underlying rib or soft tissue.Differentiationof benign from rnalignant localized mesothelioma can not be made by imaging diagnosis.As malignantlocalized mesothelioma often recurrs after surgery,closely following-up is recommended.