老年患者肺部病变合并胸腔积液的CT诊断价值

目的：分析老年肺部病变合并胸腔积液患者的CT表现，探讨CT在良恶性胸腔积液中的鉴别诊断价值。方法：回顾性分析72例经临床和病理证实的老年肺部病变合并胸腔积液患者的CT资料。结果：72例中恶性肿瘤31例（43％），肺结核28例（39％），肺部炎性病变13例（18％）。单侧胸腔积液45例，双侧胸腔积液27例，包裹性胸腔积液26例；中、大量胸腔积液多为恶性肿瘤（58％）。上肺叶病灶合并胸腔积液者多为肺结核（92％），下肺叶病灶合并胸腔积液者多为恶性肿瘤（59％）。不规则胸膜增厚、纵膈胸膜增厚者多为恶性肿瘤（80％）。结论：详细分析胸腔积液、原发病灶和胸膜增厚的CT特征，对提高诊断准确率有很大帮助。

Value of CT in diagnosing lungs lesion with pleural effusion in elderly patients

Objective ： To analyze the CT manifestations of lungs lesion with pleural effusion in elderly patients and evaluate its application to distinguish malignant pleural effusions from benign ones. Methods： Seventy two patients with complete information of images, clinic and pathology were analyzed retrospectively. Results： Thirty one of 72 cases were malignant tumor, 28 cases were tuberculosis and 13 cases were pneumonia. Unilateral pleural effusion were found in 45 cases, bilateral in 27 cases and encapsulated in 26 cases. Also, a large amount of pleural effusions were mostly found in malignant tumor. Lesions that located in upper lobe with pleural effusion were mostly tuberculosis, and lower lobes with pleural effusion were mostly malignant tumor; 47 of 72 cases were found with pleural thickening, and irregular or mediastinal pleural thickening were mainly malignant tumor. Conclusion： It is useful to improve the diagnostic accuracy of pleural effusion in elderly patients through exactly analyzing the CT leatures of pleural effusion, the primary lesion and pleural thickening.