恶性胸膜间皮瘤的CT诊断与鉴别诊断

目的分析恶性胸膜间皮瘤的CT表现,提高对该病的诊断水平。方法回顾性分析14例经手术或穿刺病理证实的恶性胸膜间皮瘤的CT表现,全部病例均行螺旋CT平扫,其中9例加增强扫描。结果所有的病例均表现为不同程度的胸膜增厚,其中弥漫性胸膜增厚10例。14例中,呈结节状胸膜增厚4例,肿块状胸膜增厚7例,环状胸膜增厚3例,胸膜增厚≥1cm者12例。合并胸腔积液、纵膈固定、患侧胸腔体积缩小10例。结论恶性胸膜间皮瘤的CT表现有一定的特征性,CT在恶性胸膜间皮瘤的诊断与鉴别诊断中有重要的价值。

CT Diagnosis and Differential Diagnosis of Malignant Pleural Mesothelioma

Objective To study the CT features of malignant pleural mesothelioma, so as to improve diagnosis accuracy of the disease. Methods The CT materials of 14 patients with malignant pleural mesothelioma which were proved by surgery or histopathology were analyzed retrospectively. CT plain scan were performed in all the cases, 9 cases of them were received both CT plain scan and contrast CT scan. Results All the cases demonstrated different level pleural thickening including diffuse pleural thickening（n=10）. In all the cases, there were nodular pleural thickening （n=4）, lumpy pleural thickening （n=7）, ringqike pleural thickening（n=3）. Pleural thickening which was more than 1.0 cm were found in 12 cases. Pleural effusion （n=10）, mediastinum immobilization （n=10） and thoracic cavity stricture in the trouble side （n=10） were also revealed. Conclusion The CT manifestations of malignant pleural mesothelioma are diagnostic. CT plays an important role in the diagnosis and differential diagnosis of the disease.