Im J G, Webb W R, Rosen A, Gamsu G
Department of Radiology, Thoracic Imaging, University of California San Francisco 94143.
Radiology. 1989 Apr;171(1):125-31. doi: 10.1148/radiology.171.1.2928515.
The appearance of the costal pleura at high-resolution computed tomography (CT) was evaluated with a cadaver and 25 normal subjects. This was contrasted with the high-resolution CT appearance of the costal pleura in 15 patients with mild pleural thickening, 13 of whom had been exposed to asbestos. On high-resolution CT scans in the normal subjects, a 1-2-mm-thick line of soft-tissue attenuation at the point of contact between lung and chest wall represents the visceral and parietal pleura, pleural contents, endothoracic fascia, and innermost intercostal muscle. In a paravertebral location, the innermost intercostal muscle is lacking, and a thin line seen on high-resolution CT scans reflects pleura and endothoracic fascia. Transverse thoracic and subcostal muscles and extrapleural fat pads can be seen as tissue internal to a rib and may be confused with pleural thickening. In 13 of the 15 patients with mild pleural thickening, the 1-3-mm-thick pleura was separable from the underlying normal intercostal muscle by a layer of extrapleural fat. High-resolution CT was more sensitive than CT with 1-cm collimation in depicting this degree of pleural abnormality.
利用一具尸体和25名正常受试者，对高分辨率计算机断层扫描（CT）下肋胸膜的表现进行了评估。并将其与15例轻度胸膜增厚患者（其中13例曾接触石棉）的肋胸膜高分辨率CT表现进行对比。在正常受试者的高分辨率CT扫描中，肺与胸壁接触点处1-2毫米厚的软组织衰减线代表脏层和壁层胸膜、胸膜内容物、胸内筋膜和最内层肋间肌。在椎旁位置，最内层肋间肌缺失，高分辨率CT扫描上看到的细线反映胸膜和胸内筋膜。胸横肌和肋下肌以及胸膜外脂肪垫可被视为肋骨内部的组织，可能与胸膜增厚相混淆。在15例轻度胸膜增厚患者中的13例，1-3毫米厚的胸膜可通过一层胸膜外脂肪与下方正常肋间肌分离。在描绘这种程度的胸膜异常方面，高分辨率CT比1厘米准直的CT更敏感。
