CT在恶性胸膜间皮瘤诊断中的价值

The Value of CT in Diagnosis of Malignant Pleural Mesothelioma

目的探讨CT在恶性间皮瘤诊断中的价值。方法回顾分析9年来我院经手术或/和病理证实的42例恶性胸膜间皮瘤的CT表现，并与12例手术所见作了比较。结果结节状或肿块状胸膜增厚（97．6％）是胸膜间皮瘤最常见的CT表现，有诊断性的表现为胸膜增厚〉1cm（59．5％），环状胸膜增厚（41．5％），病变累及纵隔胸膜（92．9％）或叶间裂（69．0％），病变侵犯周围胸壁或／和肋骨、纵隔、心包、膈肌等邻近组织或器官（65．9％），1例呈胸内巨大肿块，42．9％病例可见纵隔或，和肺门淋巴结肿大。在CT和手术所见的比较中，CT正确检出了65％的对周围组织或器官的侵犯，漏诊的有35％。结论CT在恶性胸膜间皮瘤的诊断、分期上有重要价值，是治疗前的标准诊断方法。

Objective To evaluate the values of CT in diagnosis of malignant pleural mesothelioma. Methods The CT findings of 42 cases of malignant pleural mesothelioma proved in pathology over a nine years period were analyzed retrospectively, and compared with the operative findings of 12 cases among them performing thoracotomy, Results The nodular and/or lumpy diffuse pleural thickening（97.6%） were the most common CT findings. The diagnostic CT appearances were pleural thickening more than 1 cm （59.5%）, rindlike pleural thickening （41.5%）, mediastinal （92.9%）or fissural（69.0%） pleural involvement and extended through the pleural cavity invasive of the chest wall, lung, mediastinum and diaphragm（65.9%）. 1 case presented a large mass and 42.9% of the cases had mediastinal and/or hilum lymph node enlargement, CT findings in comparison with that operation, CT detected correctly 65% of the invasive diseases of chest wall, mediastinum and diaphragm, 35% of the pathologic changes missed diagnosis. Conclusions CT is of important value to the diagnosis, and staging of malignant pleural mesothelioma,and may be considered to be a standard diagnostic method prior to therapy.