摘要
目的:评价各种影像检查在胸膜间皮瘤诊断中的作用。材料与方法:回顾性分析47例经临床、手术及病理证实的胸膜间皮瘤的影像学资料,所有病人均经胸部X线平片检查;27例经超声检查,其中11例在超声引导下进行了经皮胸膜活检;10例经CT检查;17例经MRI检查。结果:胸部X线平片表现为单发肺野内肿块4例,波浪状胸膜增厚、多发性胸膜结节或肿块33例,纵隔影增宽3例,心包积液样改变3例,仅表现为胸腔积液4例。超声检查均把胸膜结节或肿块同胸水加以鉴别,并在11例中成功地引导了胸膜活检。CT显示叶间胸膜肿块1例,广泛性胸膜增厚、结节或肿块9例,均合并不同程度胸水。MRI均显示胸膜增厚、结节或肿块,包绕患侧肺组织,肿瘤在T1加权图像上呈中等信号,在T2加权图像上呈高信号。病变侵犯纵隔11例,膈肌3例,延伸入肺叶间裂2例,纵隔淋巴结转移3例,肿瘤直接侵犯腹膜1例。结论:胸部X线平片、超声、CT和MRI在胸膜间皮瘤的诊断中具有相互补充作用。胸部X线平片仍然是首选的方法,是各种影像检查的基础。超声可以弥补X线平片的某些不足。CT在评价肿瘤的侵犯范围方面优于X线平片,CT和MRI在确定肿瘤的侵犯范围和程度方面具有相同作用,但由于MR具?
Purpose:Toevaluatetheusefulnesofvariousimagingmodalitiesindiagnosisofpleuralmesothelioma.Materialsandmethods:Imagingdatain47patientswithclinicalyandpatho-logicalyprovedpleuralmesotheliomawerestudiedretrospectively.Plainchestfilmsweredoneinalpatients;sonographyin27,sonographyguidedpercutaneouspleuralneedlebiopsyin11of27patients;CTin10andMRIin17.Results:Plainfilmsshowedsolitarymassin4cases,wavypleuralthickeningandpleuralnodulesormassesin33,wideningofmediastinalshadowin3,efusion-likechangeofpericardiumin3andonlypleuralefusionin4.Sonographyhadbenefittodelineatepleuralnodulesormasesfrompleuralfluidinalpatientsandtoguidesuccessfulypercutaneousneedlebiopsyofthepleurain11cases.CTscansidentifiedamasofinterlobarfissurein1case,anddifusepleuralthickeningandpleuralnodulesormassesfromvariableamountsofpleuralfluidin9cases.OnMRimagingalpatientshadpleuralthickening,nodulesormassessuroundingthelungontheafectedside.ThesetumorshadasignalofintermediateintensityonT1-weightedimages,whileonT2-weightedimagesaslightincreaseinsignalintensityofthemaseswasseen.Thelesionextendedintomediastinumin11cases,diaphragmin3,andspreadedintotheinterlobarfissuresin2cases.Lymph-adenopathywasdemonstratedwithMRIin3patients.DirectretroperitonealextensionwasseenonMRimagingin1case.Conclusion:Therolesofplainfilms,sonography,CTandMRIintheevaluationofpleuralmesotheliomaarecomplementary.Plainfilmsremaintheinitialchoice.Sonographycouldsupplementtheplainfilmsinsomedegree.CThasbenshowntobesuperioroverplainfilmsinevaluationofthisneoplasm.CTandMRIcouldprovidesimilarinformationsfordeter-minationofextentofthetumor,MRscansareslightlysuperioroverCTforappreciationofinvolve-mentoftheminorfissure,diaphragmandperitonium,becauseofitsmultiplanarcapability.Ontheotherhand,CTismoresensitiveindemonstrationofcalcificationwithinthetumorandribdestruc-tion.Sonography-guidedbiopsyissafe,simpleandaccurate.Rationaluseofvariousimagingmodali-tieswouldimprovethediagnosticaccuracyofmesothelioma.Finaly,theauthorsproposedanopti-malimagingapproachindiagnosisofpleuralmesothelioma.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1996年第8期515-519,共5页
Chinese Journal of Radiology
关键词
胸膜肿瘤
间皮瘤
X线摄影术
CT
NMR
成像
PleuralneoplasmsMesotheliomaRadiographySonographyTomog-raphy,X-raycomputedMagneticresonanceimaging