摘要
目的了解恶性胸膜间皮瘤(malignant pleural mesothelioma MPM)的X线和CT影像学表现,提高对其影像诊断的认识水平。方法收集2012年1月至2017年1月经病理证实的12例MPM患者资料。所有患者均同时行胸部DR摄片和CT检查,回顾性分析其影像学表现。结果 X线检查发现MPM患者11例可见不同程度的胸腔积液,胸膜增厚7例,胸膜钙化1例,肺内转移2例,邻近肋骨破坏1例;胸腔以单侧、大量积液为主,X线不能对患者胸膜增厚的形态、心包及淋巴结转移情况进行清晰的显示。CT检查发现,12例MPM中均可见胸膜增厚,11例伴不同程度的胸腔积液,结节状及肿块状胸膜增厚均不规则,局部突向肺内,增强扫描呈轻中度不均匀强化,病灶内见不强化囊变坏死区,双肺内转移2例,肋骨破坏2例,心包积液2例,胸膜钙化1例,纵隔、肺门淋巴结转移5例;患者CT检查胸膜增厚类型多为弥漫型,增厚形状以结节状为主。12例MPM患者中,人钙结合蛋白(CR)阳性11例,间皮细胞(MC)阳性7例,细胞角蛋白(CK)阳性4例,细胞角蛋白5/6(CK5/6)阳性3例,癌胚抗原(CEA)阳性1例。MPM患者中阳性标志物CR、MC的检出率均较高,分别为91.7%和58.3%。结论 MPM具有一定的影像学表现特征,诊断需要与其临床资料、免疫组织化学检测结果和病理形态进行全面的考虑。
Objective To understand the X-ray and CT findings of malignant pleural mesothelioma（MPM） to improve the recognition of imaging diagnosis. The data of 12 MPM patients pathologically confirmed from January 2012 to MethodsJanuary 2017 were collected. All the patients have undergone chest DR and CT at the same time, and their imaging manifestations were retrospectively analyzed. Results It was identified in the X-ray examination that there were 11 cases of pleural effusion of different degrees, 7 case of pleural thickening, 1 case of pleural calcification, 2 cases of intrapulmonary metastasis and 1 case of adjacent rib destruction; pleural cavity mainly manifested as unilateral and large amount of effusion, and X-ray failed to clearly display the shape of pleural thickening, pericardium and lymphatic metastasis. It was identified in the CT that there were 12 cases of pleural thickening, 11 cases of pleural effusion of different degrees, 2 cases of bilateral intrapulmonary metastasis, 2 cases of rib destruction, 2 cases of hydropericardium, 1 case of pleural calcification and 5 cases of mediastinum and hilar lymphatic metastasis. Among 12 cases, there were 11 cases of CR positive, 7 cases of MC positive, 4 cases of CK positive, 3 cases of CK5/6 positive and 1 case of CEA positive. MPM patients had a relatively high CR and MC detection rate, 91.7% and 58.3%, respectively. Conclusion MPM has some imaging features. The diagnosis requires comprehensive consideration in combination with its clinical data, immunohistochemical results and pathological morphology.
作者
王文尚
黄其文
梁志聪
麦远其
WANG Wen-shang;HUANG Qi-wen;LIANG Zhi-cong;MAI Yuan-qi(Department of Radiology;Department of pathology,Maoming People＇s Hospital,Maoming 525000,China)
出处
《广东医科大学学报》
2018年第4期437-440,共4页
Journal of Guangdong Medical University
