Liu Jia, Li Wenwu, Huang Yong, Liu Yuhui
Department of Radiology, Shandong Tumor Hospital, Affilialed to Shandong Acadaemy of Medical Sciences, Jinan 250017, China;School of Medicine and Life Scineces, University of Jinan-Shandong Acadamy of Medical Scineces, Jinan 250007, China.
Department of Radiology, Shandong Tumor Hospital, Affilialed to Shandong Acadaemy of Medical Sciences, Jinan 250017, China.
Zhongguo Fei Ai Za Zhi. 2014 May;17(5):406-10. doi: 10.3779/j.issn.1009-3419.2014.05.07.
The rate of pleural metastasis in peripheral lung cancer is high, and the dry pleural metastasis easily missed diagnosis preoperatively and cause unnecessary surgery. Therefore, preoperative diagnosis is particularly important. To review the multislice spiral computed tomography (MSCT) image of peripheral lung cancer with dry pleural dissemination, and to discuss its diagnostic value for understanding the dry pleural dissemination.
Reviewed and analyzed the MSCT images of pathologically or clinically diagnosed peripheral lung cancer with dry pleural dissemination in 27 patients. Analyze the imaging characteristics respectively from pleural thickening and pleural nodules.
The dry pleural dissemination of lung cancer were detected in 85% by CT. The rate of CT detection of dissemination on the visceral pleura and the interlobar pleura were 63% and 91%, respectively. 26 cases were with multiple pleural nodules, all were located on the same side with the primary lesions; 8 cases were with peritoneum visceralis nodules that are mostly circular with diameters of 3 mm-15 mm. The lung-nodules interfaces were clear. 23 cases had interlobar pleura nodules (all with more than 6 nodules), some are big (diameter >5 mm) while some are small (diameter <5 mm). The nodules are arranged along the interlobar pleura as beaded string or in clusters around the interlobar pleura. 15 cases were with pleural thickening, including band-like, uneven, or both exist at the same time. There are more mixed type in this group (63%).
MSCT has great diagnostic value for peripheral lung cancer with dry pleural dissemination, especially with high accuracy of pleural nodules.
周围型肺癌胸膜转移率较高，干性胸膜转移术前易漏诊，导致不必要的手术。因此，术前诊断尤为重要。回顾分析周围型肺癌干性胸膜播散的多层螺旋计算机断层扫描（MSCT）图像，探讨其对干性胸膜播散的诊断价值。
回顾性分析27例经病理或临床诊断为周围型肺癌干性胸膜播散的MSCT图像。分别从胸膜增厚和胸膜结节方面分析其影像特征。
CT对肺癌干性胸膜播散的检出率为85%。脏层胸膜和叶间胸膜播散的CT检出率分别为63%和91%。26例有多个胸膜结节，均位于原发灶同侧；8例有脏层胸膜结节，多呈圆形，直径3mm - 15mm，肺结节界面清晰。23例有叶间胸膜结节（均超过6个），部分较大（直径>5mm），部分较小（直径<5mm），结节沿叶间胸膜呈串珠状排列或在叶间胸膜周围簇状分布。15例有胸膜增厚，包括带状、不均匀或两者同时存在，本组以混合型居多（63%）。
MSCT对周围型肺癌干性胸膜播散具有较大诊断价值，尤其是对胸膜结节的诊断准确性较高。
