胸膜间皮瘤的CT诊断

CT diagnosis of pleural mesothelioma

目的 :探讨胸膜间皮瘤CT影像形成的病理基础以及CT对本病的诊断价值。方法 :采用CT影像与病理对照的方法 ,对 18例胸膜间皮瘤的病例进行回顾性分析。其中良性胸膜间皮瘤 8例 ,恶性胸膜间皮瘤 10例。结果 :发生在右侧胸腔 10例 ,左侧胸腔 8例。 6例胸膜上有明显的孤立性结节 ,为良性胸膜间皮瘤。 3例胸膜上有多发结节并有局限性胸膜增厚 ,其中 1例为恶性 ,2例为良性。 9例胸膜上有散在的形态不规则结节 ,均伴有恶性胸膜增厚及胸腔积液 ,均为恶性。恶性胸膜间皮瘤较良性胸膜间皮瘤强化明显。结论 :CT在胸膜间皮瘤的定性诊断及确定病变的范围、形态以及胸壁和纵隔结构是否受侵犯有很大价值。

Objective To evaluate the correlation between the CT findings of mesothelioma and pathologic changes,and determine the usefulness of CT in the differential diagnosis of pleural diseases.Method The authors retrospectively studied the CT imaging of 18 patients with mesothelioma proved histologically.Results Of 18 patients 8 were benign,10 patients were malignant.There were 10 cases with located the right thorax,the others situated the left thorax.The obvious solitary pleural nodules in the 6 patients were benign.Of 3 patients with multiple nodules and partial pleural thickening,1 case was malignant,2 cases were benign.Multiple irregular nodules with diffuse pleural thicking and pleural effusion were observed on CT scans in 9 patients.These were malignant mesothelioma.Benign and malignant mesothelioma were opacity in all 18 patients.Malignant mesothelioma enhanced significantly greater than benign mesothelioma.Conclusion CT is helpful in detecting the location,extent of pleural lesions and the involvement of mediastinum,and differential diagnosis of benign and malignant pleural mesothelioma.