良、恶性胸腔积液的CT鉴别诊断

目的评价良、恶性胸腔积液的CT特征性表现.资料与方法回顾性分析38例恶性胸腔积液和56例良性胸腔积液的CT征象.结果良性积液中,双侧占41.1%,胸膜增厚占19.6%,呈弥漫均匀增厚,纵隔胸膜受累占10.7%,胸膜外脂肪层明确显示占71.4%,厚度＞3 mm占41.1%,平均厚度5.7 mm;恶性积液中,双侧占15.8%,胸膜增厚占57.9%,主要呈不规则弥漫或局限性增厚,累及纵隔胸膜占36.8%,胸膜外脂肪层显示占60.5%,＞3 mm占26.3%,平均2.9 mm.结论单侧、大量积液且张力高,胸膜不规则增厚,纵隔胸膜受累对恶性诊断有特异性;而胸膜无或轻度弥漫规则增厚,胸膜外脂肪层增厚多提示良性.

Differential Diagnosis of CT in Benign and Malignant Pleual Effusion

Objective To evaluate the CT features of malignant and benign pleural effusion.Materials and Methods CT features of 94 patients( 38 malignant and 56 benign) with pleural effusion were analyzed retrospectively.Results n benign group, 23(41.1%)cases with bilateral effusion, 11(19.6%)cases with pleural widespread and regular thickening, mediastinal pleura were involved in 6(10.7%) cases, EPF were demonstrated in 40(71.4%) cases , among these 23(41.1%)cases, the thickness of EPF>3mm were shown, the mean thickness of EPF was 5.7mm; In malignant group, 6(15.8%)cases with bilateral effusion, 22(57.9%) cases with pleural widespread and irregular thickening or limited, mediastinal pleura were involved in 14(36.8%) cases , EPF were demonstrated in 23(60.5%) cases, among these 10(26.3%) cases, the thickness of EPF>3mm were shown, the mean thickness of EPF was 2.9mm.Conclusion It is the feature of malignant pleural effusion that unilateral, mass pleural effusion, and pleural thickening irregular or limited with involvement of mediastinal pleura; without pleural or slightly regular thickening and the thickening of EPF are useful for diagnosis of benign pleural effusion.