胸部大面积致密病变的影像诊断（附52例分析）  

Imaging Diagnosis of Extensive Opacity in the Chest(Analysis of 52 Cases)

作　　者：王宏德[1] 顾小兰[1] 施的美[1] 

机构地区：[1]江苏省肿瘤防治研究所放射科,江苏省肿瘤防治研究所病理科

出　　处：《实用放射学杂志》1994年第3期133-136,共4页Journal of Practical Radiology

摘　　要：笔者分析了５２例经病理证实的胸部大面积致密病变的传统Ｘ线、ＵＳ和ＣＴ检查，探讨其诊断价值和限制。当Ｘ线见胸部大面积致密病变。为多量胸水或／和广泛性胸膜增厚时，宜先选用ＵＳ检查，不论胸膜或伴肺不张的肺占位病变一般可明确诊断，其定性诊断率为８０．８％，其中胸膜和肺的占位病变诊断率分别为８３．３％和７５％。必要时再抽胸水摄胸片或ＣＴ检查，ＣＴ的定性诊断率为７０％。ｘ线见肺不张时，先摄气管支气管断层片，观察有否支气管病变及肺门纵隔淋巴结肿大等，ｘ线定性诊断率为５７．２％，疑难者再作ＵＳ检查，其定性诊断率为８５．７％，对放射性肺炎实变内的肿瘤改变的检查宜用ＵＳ较ＣＴ为佳。52 cases of extensive opacity in the chest proved by pathology were studied by examinations combinedwith conventional X一ray,US and CT. Diagnocstic value and limitation of these methods were evaluated. When extensiveopacity of the chest showed after X一ray examination was the massive pleural effusion and/or extensive pleural thicken-ing,US was used first,the pleural lesion or pulmonary space一occupying lesion with atelectasis might be generally diag-nosed definitely with positive rate of 80.8%and the nature of space一occupying lesion of the pleura and lung might be defined with accurate rate of 83.3%and 75% respectively.Some cases were checked by X一ray film or CT examinationafter aspirating pleural fluid and CT scanning with positive rate of 70%. When the chest film showed the case with at-electasis, tomography of the trachea and bronchus were taken,the positive or negative endobronchial lesion and enlarge-ment of hilum一mediasternal lymph nodes, might be determined, The results showed that X一ray diagncsis in determiningthe nature of lesions was 57.2%. As in the difficult cases,the additional US scanning might increase the accurate rateto 85. 7%and especially in the investigation of carcinomatous lesion in the consolidation of radiation pneumonitis,US isbetter than CT.

关 键 词：胸部病变 X线 CT 影像学诊断 

分 类 号：R816.4[医药卫生—放射医学]