Leung A N, Müller N L, Miller R R
Department of Radiology, University of British Columbia, Vancouver, Canada.
AJR Am J Roentgenol. 1990 Mar;154(3):487-92. doi: 10.2214/ajr.154.3.2106209.
The CT features of benign and malignant pleural diseases have been described. However, the accuracy of these features in the differential diagnosis of diffuse pleural disease has not been assessed before. Without knowledge of clinical or pathologic data, we reviewed the CT findings in 74 consecutive patients with proved diffuse pleural disease (39 malignant and 35 benign). The patients included 53 men and 21 women 23-78 years old. Features that were helpful in distinguishing malignant from benign pleural disease were (1) circumferential pleural thickening, (2) nodular pleural thickening, (3) parietal pleural thickening greater than 1 cm, and (4) mediastinal pleural involvement. The specificities of these findings were 100%, 94%, 94%, and 88%, respectively. The sensitivities were 41%, 51%, 36%, and 56%, respectively. Twenty-eight of 39 malignant cases (sensitivity, 72%; specificity, 83%) were identified correctly by the presence of one or more of these criteria. Malignant mesothelioma (n = 11) could not be reliably differentiated from pleural metastases (n = 24). We conclude that CT is helpful in the differential diagnosis of diffuse pleural disease, particularly in differentiation of malignant from benign conditions.
良性和恶性胸膜疾病的CT特征已有描述。然而，这些特征在弥漫性胸膜疾病鉴别诊断中的准确性此前尚未得到评估。在不了解临床或病理数据的情况下，我们回顾了74例经证实的弥漫性胸膜疾病患者（39例恶性和35例良性）的CT表现。患者包括53名男性和21名女性，年龄在23至78岁之间。有助于区分恶性和良性胸膜疾病的特征有：（1）环形胸膜增厚；（2）结节状胸膜增厚；（3）壁层胸膜增厚超过1cm；（4）纵隔胸膜受累。这些表现的特异性分别为100%、94%、94%和88%。敏感性分别为41%、51%、36%和56%。39例恶性病例中有28例（敏感性为72%；特异性为83%）通过存在一项或多项这些标准而被正确识别。恶性间皮瘤（n = 11）与胸膜转移瘤（n = 24）无法可靠区分。我们得出结论，CT有助于弥漫性胸膜疾病的鉴别诊断，尤其是在区分恶性与良性疾病方面。
