恶性间皮瘤的MR I表现分析

目的：探讨恶性间皮瘤(MM)的 MRI表现特征。方法回顾分析18例经病理证实的 MM的 MRI资料,其中胸膜 MM 15例,腹膜 MM 3例。所有病例都进行 MRI扫描,序列包括 MRI平扫、MRI增强、扩散加权成像(DWI)。评价 MM的部位、形态、大小、信号、强化方式、扩散特点、周围组织的侵犯情况和伴随改变。结果15例胸膜 MM中弥漫型14例、局限型1例,3例腹膜MM均为弥漫型。14例弥漫型胸膜 MM中10例胸膜增厚>3 cm,平均(5.3±3.8)cm,6例形成软组织肿块；3例弥漫型腹膜 MM中2例腹膜增厚>3 cm,形成软组织肿块。T1 WI稍低信号7例、等信号11例,T2脂肪抑制序列等低信号4例、稍高信号10例、高信号4例；18例MM病灶在DWI上均呈高信号。18例MM增强扫描均表现为持续强化,在180 s强化最明显。8例伴有淋巴结肿大(8/18)；11例胸膜 MM病侧胸廓明显缩小,其中7例伴有胸壁侵犯。结论 MM的 MRI表现有一定特征性,MRI检查有助于治疗前的准确诊断。

MRI features of malignant mesothelioma

Objective To investigate the MRI features of malignant mesothelioma(MM).Methods MRI data of 18 cases of MM confirmed by pathology were analyzed retrospectively.1 5 cases were malignant pleural mesothelioma,and 3 cases malignant peritone-um mesothelioma.MRI scans were performed in all cases,including MRI plain scan,MRI enhancement and diffusion weighted ima-ging(DWI).We evaluated the location,shape,size,signal,enhancement mode,dispersion characteristics,invasions of surrounding tissues and concomitant changes of MM.Results Among the 15 cases of malignant pleural mesothelioma,14 cases were diffuse type, 1 case was localized type,and 3 cases of malignant peritoneum mesothelioma were all diffuse types.10 of 14 diffuse malignant pleural mesothelioma had a thickening pleural of more than 3 cm,the average thickness was (5.3±3.8)cm,in which soft tissue mass was showed in 6 cases.2 of 3 diffuse malignant peritoneum mesotheliom had a thickening peritoneal of more than 3 cm with soft tissue mass.On T1 WI images,slightly low signal were showed in 7 cases,and equal signal in 1 1 cases.On T2 fat suppression sequence,low signal were showed in 4 cases,slightly high signal in 10 cases and high signal in 4 cases.On DWI,18 cases of MM lesions all showed high signal.On enhanced scan,continuous enhancement were showed in 1 8 cases of MM and the enhancement was the most obvious at 180 s.8 cases with lymph node enlargement (8/18).The diseased lateral thoracic profile was significantly narrowed in 11 cases with malignant pleural mesothelioma,of which 7 cases with chest wall invasion.Conclusion The MRI features of MM have certain char-acteristics,and MRI examination will help to make accurate diagnosis before treatment.