胸膜转移瘤的CT诊断价值  

The CT diagnose of pleural metastasis tumour

作　　者：谌力群 韩凯滨 潘恒[2] 黄小茹 周炳操 黄月华 

机构地区：[1]广东农垦中心医院放射科,广东湛江524002 [2]中山大学附属第二医院放射科

出　　处：《影像诊断与介入放射学》2007年第3期121-122,共2页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨胸膜转移瘤的CT特征,提高胸膜转移瘤的认识与诊断水平。方法回顾性分析近年在我院做CT检查的30例经病理及临床证实胸膜转移瘤病例,使用GE公司生产的Hispeed.zx/i型单层螺旋CT机,层厚、层距均为10mm,螺距1.5,病分病例行5mm薄层或高分辩扫描,所有病例均先行平扫,25例做了增强扫描。结果胸膜转移瘤的CT表现依次为:包裹性胸腔积液伴不规则胸膜增厚(56.6%)、胸膜结节及结节状胸膜增厚(46.6%)、胸膜软组织肿块(13.3%)、少量气胸(1.0%)等,包裹性胸腔积液及胸膜结节或结节状胸膜增厚共占76.6%,增强扫描胸膜软组织灶呈中等度以上强化,CT值>20HU,66.6%病例并其他胸内转移征象,73.3%原发灶为肺癌,20.0%找不到原发灶。结论螺旋CT能发现大部分胸膜转移瘤,结合原发灶病史及其他胸内转移征象,大部分病例能作出正确诊断,但对表现为少量胸腔积液或轻度带状胸膜增厚与反应性改变尚难鉴别,诊断有局限性。Objective To discuss the CT characteristic of pleural metastasis tumour,enhance the diagnostic level of pleural metastasis tumour.Methods Review 30 cases which have been performed CT scan in our hospital during March 2002 to June 2003,which have been approved to pleural metastasis tumour by pathology and clinic. Make use of GE Hispeed.zx/i spiral CT,10mm thickness,10mm increment, l.5 pitch,some of them use 10mm or high resolution mode.All cases have been performed normal scan,25 cases with contrast scan. Results The CT representation of pleural metastasis tumour are encapsulated pleural effusion with irregular pleural thickening（56.6%）,nodular pleural thickening（46.6%）,pleural masses （13.3%）,pneumothorax （3.3%）,etc. Encapsulated pleural effusion and nodular pleural thickening are 76.6%,use contrast mode to scan pleural pathological changes enhance upon middle level,CT value increment 〉 20HU,there are 66.6% cases with other chest metastasis symptom,73.3% primary lesion are pulmonary cancer,and 20% no primary lesion are found. Conclusion Combine primary lesion history and other chest metastasis symptom,Spiral CT examination can differentiate most of pleural metastasis tumour,but it is difficult to differentiate the cases between with a little pleural effusion or light band pleural thickening and reactive alteration.

关 键 词：X-线计算机 体层摄影术 胸膜转移瘤 

分 类 号：R734.3[医药卫生—肿瘤]