胸腔积液时胸膜增厚的CT鉴别诊断

CTstudyindifferentialdiagnosisofpleuralthickeningwithpleuraleffusion

目的：分析胸腔积液病人的胸部ＣＴ片，总结出对鉴别胸膜良、恶性病变有价值的ＣＴ征象。材料和方法：对１００例胸腔积液病人，利用最大拟然判别法，把它们的征象转化成计分值，并对４５例胸腔积液病人进行前瞻性判别。结果：ＣＴ对结核性胸膜病变的诊断正确率为６７．０％，与主要临床症状结合正确率为８７．５％；ＣＴ对恶性胸膜病变的诊断正确率为６９．０％，与主要临床症状结合正确率达８６．２％。结论：ＣＴ对胸膜病变的良、恶性鉴别诊断有价值，与主要临床症状结合能提高诊断的正确率。对疑难病例，应提倡胸膜穿刺活检。

Purpose:ToanalysetheCTfindingsin100patientswithprovedpleuraldisease,andfindthefeatureswiththepurposeofdistinguishingmalignantfrombenignpleuraldiseases.Materialsandmethods:Thehelpfulfeaturesof100patientswithpleuraldiseaseweretranslatedintoscoresbymeansofdiscriminationmethodoflargelog-likelihood,andanother45patientswithpleuralefeusionwerediagnosedbyuseofthescoresinaperspectiveway.Results:TheaccuracyofCTdiagnosiswas67.0%fortuberculouspleurisyand87.5%bycombinedCTandclinicalsymptoms;theaccuracywas69.0%formalignantpleuraldiseasebyCTaloneand86.2%bycombinedCTandclinicalsymptoms.Conclusion:CTwashelpfulindiferentialdiagnosisofpleuraldiseasesandcouldimprovetheaccura-cyofdiagnosiswhencombinedwithclinicaldata.Pleuralbiopsyorthoracotomywassuggestedforthosepatientswithdifficultdiagnosis.