胸部脂肪瘤的影像学诊断(附14例报告)

目的探讨胸部脂肪瘤的影像学表现及检查方法优选. 资料与方法搜集胸部脂肪瘤14例资料,包括肺脂肪瘤2例,胸壁脂肪瘤4例,纵隔脂肪瘤3例,胸腺脂肪瘤3例,横膈脂肪瘤1例,右心房脂肪瘤1例,全部病例均有胸部正侧位片,12例进行了CT检查,1例进行了MRI检查,对全部患者的影像学表现进行分析. 结果胸部正侧位片病灶发现率78.6%,漏诊原因与肿瘤密度过低,肿瘤沿胸壁深部肌间隙浸润生长或肿瘤位于平片上较隐蔽的部位有关.CT检查不仅可进行精确的定位诊断和分类诊断,而且能作出定性诊断,但应常规摄脂肪窗片.MRI对这类肿瘤最敏感,它对病变的发现、定位、分类诊断及定性诊断有决定性意义. 结论胸部正侧位片是胸部脂肪瘤的首选检查方法,但病变的分类诊断与定性诊断需依赖胸部CT与MRI,其中MRI是该类疾病的最佳检查方法.

Imaging Diagnosis of Chest Lipoma (Reports of 14 Cases)

Objective To investigate imaging features of chest lipoma and the optimal method of examinations. Materials and Methods 14 cases of chest lipoma included lung lipoma (n=2), chest wall lipoma (n=4), mediastinal lipoma (n=3), thymolipoma(n=3), diaphragm lipoma (n=1) and right atrium lipoma (n=1). All patients were taken chest films. 12 added to CT scans and 1 added to MR. Imaging findings of chests lipoma were retrospectively analyzed. Results The detected rate of the lesion by chest films was 78.6%. The major reasons of missing detection were lower density of the masses, or the mass in invasive growth along chest wall or concealed location. CT was superior to plain film in location, classification and characterization of chest lipoma. MRI was most sensitive to chest lipoma, especially in detection, location, classification and characterization. Conclusion Plain chest radiography should be selected as a screen method for the detection and diagnosis of chest lipoma, but accurate diagnosis depends on CT or MRI. MRI is the best imaging method of choice in the diagnosis of the disease.