原发性胸壁肿瘤的影像学诊断(附35例分析)

Imaging Diagnosis of Primary Chest Wall Tumors(Analysis of 35 Cases)

目的 探讨原发性胸壁肿瘤的影像学表现及其诊断价值。资料与方法 搜集原发性胸壁肿瘤病例 35例 ,其中胸壁骨肿瘤 11例 ,软组织肿瘤 2 4例 ;良性 2 5例 ,恶性 10例。 35例均摄有胸部正侧位片 ,17例行CT增强扫描 ,对全部病例影像学表现进行了回顾性分析。结果 胸壁肿瘤的影像学诊断步骤为 :(1)明确肿块是否来源于胸壁 ;(2 )明确肿块来自于胸壁软组织抑或胸壁骨组织 ;(3)明确肿块是良性抑或恶性 ;(4 )肿瘤组织学分类诊断。将该组疾病影像学表现分为Ⅵ型 ,分型对肿块的定位及定性诊断均有重要的临床价值。结论 综合分析X线与CT表现 ,不仅可对大多数胸壁肿瘤进行精确的定位及定性诊断 ,而且尚可对大部分胸壁脂肪瘤。

Objective To investigate the imaging features of chest wall tumors and its diagnostic value. Materials and Methods The imaging manifestations of 35 cases of chest wall tumors were retrospectively studied, including 11 bone tumors of chest wall and 24 soft tissue tumors; benign in 25 and malignant in 10 cases. Chest P A and lateral X ray plain films were taken in all cases and enhanced CT scans in 17 cases. Results The imaging diagnostic steps of chest wall tumors were as follows: (1)First, the origination of the mass was determined; (2)Second, the soft tumor from bone tumor of chest wall was distinguished; (3)Third, the benign from malignance of the tumor was distinguished; (4)Finally, histological diagnosis of chest wall tumors was made. In addition, the imaging manifestations of chest wall tumors were divided into 6 types in this study, by which the classification could play an important role for the diagnosis of the tumors of chest wall. Conclusion Comprehensive analysis of X ray and CT features is helpful in both the location and characterization of most chest wall tumors, and histological diagnosis of some tumors such as the lipoma, hemangioma and neurogenic neoplasms of the chest wall.