胸膜原发性肿瘤的CT诊断  

CT Diagnosis of Primary Pleura Tumor

作　　者：马周鹏 于骞[2] 林观生 朱建忠[3] MA Zhou-peng;YU Qian;LIN Guan-sheng;ZHU Jian-zhong(Department of Radiology,Jinshan TCM-Integrated hospital,Shanghai 201501,China;Department of Radiology,People's hospital of Cixi city,Ningbo 315300,China;Department of Imaging center,Affiliated hospital to Taishan medical university,Taian 271000,China)

机构地区：[1]上海市金山区中西医结合医院放射科,上海201501 [2]慈溪市人民医院放射科,浙江宁波315300 [3]泰山医学院附属医院影像中心,山东泰安271000

出　　处：《CT理论与应用研究（中英文）》2018年第6期767-774,共8页Computerized Tomography Theory and Applications

基　　金：上海市金山区科委面上项目(JSKJ-KTMS-2017-10);上海市金山区中西医结合医院院内A类项目(201701)

摘　　要：目的:探讨胸膜原发性肿瘤的CT表现,提高对该类疾病的认识。方法:回顾性分析经病理学证实的24例胸膜原发性肿瘤的CT资料。结果:24例中恶性间皮瘤9例,8例表现为胸膜弥漫性增厚及多发结节,1例局限性增厚,增强较明显不均匀强化3例,不均匀轻-中等强化6例,8例见胸腔积液,3例伴有淋巴结转移,1例见肝内及肺内转移。孤立性纤维瘤7例,3例表现为梭形肿块,4例呈半球形肿块,增强不均匀轻度到明显强化,5例见胸膜尾征,2例少量胸腔积液。神经鞘瘤5例,1例表现为梭形肿块,4例呈半球形、球形肿块,增强不均匀轻-中度强化,均见胸膜尾征。纤维脂肪瘤1例表现为脂肪及纤维混杂密度梭形团块,边界较清晰,增强见较多纤维成分延迟强化。滑膜肉瘤1例表现为巨大不规则肿块,增强不均匀强化,并见左侧肾上腺转移灶环状强化。炎性肌纤维母细胞瘤1例表现为球形等及稍低密度肿块,增强不均匀延迟强化。结论:胸膜原发性肿瘤少见,不同肿瘤的CT表现各有特点,CT对其诊断及鉴别诊断有重要价值。Objective: To explore the CT findings of the primary pleural tumors and improve the understanding of these diseases. Methods: The CT of 24 cases of primary pleural tumors confirmed by pathology were analyzed retrospectively. Results: Among 24 cases, there were 9 cases of mesothelioma, 8 cases showed pleural diffuse thickening irregularly together with multiple nodules,and 1 cases showed localized thickening of the pleura,3 cases showed obvious inhomogeneous enhancement, 6 cases showed mild to moderate enhancement inhomog eneously, 8 cases of accompanied with pleural effusion, 3 cases accompanied with lymph node metastasis, 1 case accompanied with intrahepatic metastas and 1 case accompanied with intrapulmonary metastas. Among 7 cases of solitary fibroma, 3 cases were fusiform masses, 4 cases showed hemispherical masses, and all 7 cases showed mild to obvious enhancement inhomogeneously, 5 cases showed "pleural tail" sign and 2 cases accompanied with pleural effusion. 5 cases of neurilemmoma all showed "pleural tail" sign, 1 case showed fusiform mass and 4 cases showed spherical mass, and all 5 cases showed mild to moderate enhancement inhomog eneously. 1 case adipofibroma showed fusiform mass with fatty density mainly and clear boundary, and a little fibes with mild enhancement.1 case synovial sarcoma showed huge irregular mass and with inhomogeneous enhancement,accompanied with metastasis of the left adrenal with circular enhancement. 1 case inflammatory myofibroblastoma showed spherical mass with equal and mild low density, and with inhomogeneous delayed enhancement obviously. Conclusion: Primary tumor of the pleura is rare in clinic but is varied in variety, the CT characteristics of different tumors are different, and CT show important value for the diagnosis and differential diagnosis.

关 键 词：胸膜 原发性肿瘤 体层摄影术 X线计算机 诊断 

分 类 号：R814.42[医药卫生—影像医学与核医学]