胸腔入口区肿瘤影像诊断的评价

Evaluationofimagingmodalitiesindiagnosisofthoracicinlettumor

目的：评价Ｘ线、ＣＴ及ＭＲＩ等影像检查在胸腔入口区肿瘤的诊断价值。材料与方法：回顾性分析４４例经病理证实的神经源性肿瘤、肺上沟癌、甲状腺瘤、支气管囊肿、脂肪瘤等肿瘤。所有病人均有正侧位Ｘ线平片检查；２８例行ＣＴ检查；４０例行ＭＲＩ检查。结果：４２例经Ｘ线发现肿瘤阴影。２８例行ＣＴ检查，定位正确者２７例；定性正确者２５例，定性诊断正确率为８９％。４０例ＭＲＩ定位均正确；定性正确者３６例，定性诊断正确率为９０％。结论：Ｘ线平片仍是首选方法，是发现肿瘤的重要手段。ＣＴ检查对组织成分的显示优于Ｘ线检查，显示钙化、骨质破坏、坏死及脂肪等均较满意。非侵袭性的ＭＲＩ检查对胸腔入口区肿瘤诊断准确性高，是最佳的影像学检查方法，但不应列为首选检查。ＭＲＩ显示血管及臂丛神经受侵是其特有表现，显示钙化及骨质受侵不如ＣＴ扫描。

Purpose:Toevaluatetheimagingmodalitiesindiagnosisofthoracicinlettumor.Materialsandmethods:Fourty-fourpathologicalyprovedcases,includingneurogenicandthyroidtumors,superiorsulcuscarcinoma,bronchogeniccystandlipoma,werestudiedretrospectively.Plainchestfilmsweretakeninalcases,CTin28andMRIin40cases.Results:Plainfilmsdemon-stratedsolitarymasin42cases.TheacuracyoftumorlocalizationbyCTwas96%(27/28)andwas100%forMRI(40/40).ThediagnosticaccuracyofCTwas89%(25/28)and90%(36/40)forMRI.Conclusion:Plainfilmsarestilusedasinitialscreeningprocedureindetectionofthetumormass.Comparedwithconventionalradiography,CTismoresensitiveindemonstratingstructuralab-normalitiessuchascalcification,bonyerosion,necrosis,orfat.MRIisthemostaccurateandnonin-vasivebutnottheinitialimagingmodalityofchoiceforthoracicinlettumor.MRIisexcelentinde-lineatingthebloodvesselsand(or)thebrachialplexusinvolvement,avaluablediagnosticsign.However,calcificationorbonyerosion,readilyseenonCT,mayberelativelyinconspicuousonMRI.