周围型肺癌胸膜外脂肪侵犯的CT诊断价值  

Diagnostic value of CT to extrapleural fat involvement by peripheral lung cancer

作　　者：贾武林[1] 雷志丹[1] 芦运生[1] 崔剑[1] 文泽军[1] 李永丽[1] 

机构地区：[1]河南省人民医院放射科,郑州市450003

出　　处：《实用诊断与治疗杂志》2005年第11期797-798,共2页Journal of Practical Diagnosis and Therapy

摘　　要：目的:探讨周围型肺癌胸膜外脂肪侵犯的CT表现,评价其CT诊断价值。方法:选择邻近胸壁的肺部肿块作常规及高分辨CT扫描,对经手术病理证实的48例患者术前CT中胸膜外脂肪侵犯做出评价,用χ2检验对CT及手术病理结果进行比较,并计算出CT诊断的敏感性,特异性和准确度。结果:48例患者CT诊断有胸膜外脂肪侵犯32例,而手术病理结果为31例,CT假阳性5例,假阴性4例。CT诊断胸膜外脂肪侵犯的敏感性是87.1%,特异性是70.6%,准确度是81.2%。CT诊断与手术病理结果较一致,χ2值为16.44,P<0.001。肺癌侵犯胸膜外脂肪的表现为胸膜外脂肪线变窄、模糊、不规则、甚至消失,其中以胸膜外脂肪线消失为最主要表现。结论:CT诊断胸膜外脂肪侵犯有一定的优势,对于周围型肺癌术前的定性及分期具有较高的价值,但其特异性及准确度还有待提高。Objective To analyze the CT finding of extrapleural fat involvement by peripheral lung cancer, and evaluate its CT diagnostic value. Methods The patients with lung mass adjacent to the chest wall were detected by conventional CT and HRCT. CT was evaluated to make the preoperative determination of EPF involvement in 48 cases proved by operation and pathology, by using chi-square test for the pared data. And the sensitivity, specificity, and accuracy of method were also calculated. Results Thirty-two cases were judged to have evidences of extrapleural fat involvement on CT diagnosis, but 31 cases on operation and pathology. Five cases were false positive and 3 false negative extrapleural fat involvement with CT. The sensitivity of CT diagnosis for EPF involvement was 87.1%, specificity was 70.6%, and accuracy was 81.2%. CT diagnosis was approximately corresponded with the pathological result（χ^2=16.44, P〈0.01）. The CT features of extrapleural fat involvement were （1） The extrapleural fat string was disappear; （2） The extrapleural fat string became narrow and obscure; （3） The extrapleural fat string became narrow and irregular. It was the most important sign for extrapleural fat string disappear. Conclusion CT diagnosing extrapleural fat involvement is more useful value. It can be very helpful to the qualitative diagnosis and stage＇s diagnosis of peripheral lung cancer. But the specificity and accuracy of CT diagnosing extrapleural fat involvement still need enhancing.

关 键 词：肺肿瘤 胸膜 脂肪组织 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]