炎症性与癌性胸水的CT鉴别诊断

目的探讨炎症性和癌性胸水的CT表现及鉴别诊断的价值。方法回顾性分析68例经临床、手术、病理、胸水证实的炎症性和癌性胸水CT表现并进行总结。结果30例炎症性胸水中双侧16例,胸膜增厚11例,主要呈弥漫线状增厚,28例为少至中量,21例出现包裹,无1例纵隔胸膜受累。38例癌性胸水,单侧34例,21例出现大量胸水,胸膜增厚25例,主要呈不规则增厚,结节状增厚,环状增厚,纵隔胸膜受累增厚13例,无1例出现包裹。结论在CT对炎症性和癌性胸水鉴别诊断中,胸膜不规则增厚,结节状增厚,环状增厚,纵隔胸膜受累增厚对于确定癌性胸水具有重大临床意义。

THE VALUE OF CT IN DIFFERENTIAL DIAGNOSIS OF INFLAMMATORY AND CANCEROUS PLEURAL EFFUSION

Objective To explore the CT features and diagnosis of the inflammatory and cancerous pleural effusion. Methods Respectively analyzed the data of 68 cases confirmed by clinical, operation and pathology. Results Among 30 cases of inflammatory pleural effusion, 16 cases were found with bilateral effusion , 11 cases with pleural widespreading thickening. 28 cases showed small amount of pleural effusion. 21 cases were encysted with pleural effusion. None of these cases were limited with mediastinum pleura involvement. Among 38 cases of cancerous pleural effusion, 34 cases were found with unilateral effusion and 21 cases with large amount of pleural effusion. Pleural thickening were found in 25 cases which mainly showed limited, irregular thickening, tubercular thickening and irregular pleural were involved in 13 cases. None of these cases were encysted with pleural effusion. Conclusion Pleural irregular thickening of mediastinal pleural effusion have great clinical significance to define cancerous pleural effusion in the CT diagnosis of inflammatory and cancerous pleural effusion.