胸膜结核瘤的CT诊断

The diagnosis of pleural tuberculoma by computer tomography(CT)

目的探讨胸膜结核瘤的CT特征,提高该病的影像诊断水平。方法回顾性分析经病理及临床证实的8例胸膜结核瘤的CT资料。结果 8例均有或曾有过胸膜炎病史,单发胸膜结核瘤4例,多发4例,共16枚病灶,多数(10/16)位于右下胸腔;CT表现为自胸膜凸向肺野的"D"字形、椭圆形、乳头状、圆形软组织密度影,与胸膜多呈宽基底相交,边缘光滑,多数密度均匀;增强后多数(10/16)呈环形强化,部分(3/16)呈脏层胸膜缘弧线状强化,少数(2/16)均匀强化,病灶基底部胸膜移行性增厚强化,形成"胸膜尾征";6例伴有肺内结核,3例伴有胸腔积液,4例伴有胸膜钙化。结论胸膜结核瘤的CT表现具有一定的特征,结合临床病史,多可作出明确诊断。

Objective To investigate the imageology character of pleural tuberloma in multi-slice helical CT so as to im- prove the understanding of this disease. Methods We analyzed retrospectively the CT images in 8 pleural patients with tu- berculoma diagnosed by clinical or surgical pathology. Results The 8 patients had pleurisy history of tuberculosis, the half of the patients had signal pleural tuberculoma, and the other 4 patients had multiple pleural tuberculomas. There were 16 nodes of multiple pleural tuberculomas cases, which mostly located in the lower right chest （10/16）. The CT image showed ＇D＇ letter shaped, elliptic, papillary and round nodes, intersected with pleural wide base, were from the pleural to lung field. The nodes margin was smooth and the density was uniform, ring enhancement can be seen in most cases （10/ 16） on contrast CT, some were visceral pleura arc-like enhancement （3/16）. Pleural tail sign can be seen in some uniform enhancement （2/16） that was at the bottom of the nodes in the pleura side among the cases, there were six cases with in- trapulmonary tuberculosis, 3 cases with pleural effusion, four cases with pleural calcification. Conclusion Pleural tuber- culoma has some characters in CT images, so we can give correct diagnosis combined with clinical materials.