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胸膜外间隙病变的多模态影像学

"Multimodality imaging of the extrapleural space lesions".

机构信息

Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, USA.

Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

出版信息

Clin Imaging. 2021 Nov;79:64-84. doi: 10.1016/j.clinimag.2021.03.038. Epub 2021 Apr 16.

Abstract

Extrapleural space (EPS) is a potential space between the outer layer of the parietal pleura and the inner layer of the chest wall and the diaphragm. Many different pathologies including chronic inflammatory conditions, infections, trauma, neoplastic disease (both benign and malignant) as well as many infiltrative disorders can involve the EPS. It is one of the frequently overlooked entity on imaging due to relative lack of understanding of the anatomy and the imaging appearances of the diseases localized to this space. The knowledge of the EPS is essential for the radiologists as the pathologies which involve the EPS may require different treatment approach compared to pleural or parenchymal lung disease. Additionally, the EPS involvement may influence the staging and treatment planning for chest malignancies. In this review, we give an overview of the anatomy and various pathologies involving EPS, utility of different imaging modalities in the evaluation of EPS lesions with emphasis on cross sectional imaging and emerging technologies like spectral CT and its role in recognizing the imaging features which enable specific diagnosis of various pathologies.

摘要

肋膜外腔(EPS)是壁层胸膜的外膜与胸壁和横膈膜的内膜之间的潜在腔隙。许多不同的病症,包括慢性炎症、感染、创伤、肿瘤疾病(良性和恶性)以及许多浸润性疾病,都可能涉及到 EPS。由于相对缺乏对该区域解剖结构和疾病影像学表现的了解,因此在影像学上,EPS 是经常被忽视的实体之一。对于放射科医生来说,了解 EPS 是至关重要的,因为涉及 EPS 的病症可能需要与胸膜或肺实质疾病不同的治疗方法。此外,EPS 的累及可能会影响胸部恶性肿瘤的分期和治疗计划。在这篇综述中,我们概述了 EPS 的解剖结构和涉及的各种病症,以及不同成像方式在评估 EPS 病变中的应用,重点介绍了横断面成像以及新兴技术,如能谱 CT 及其在识别各种病症的特定诊断影像学特征方面的作用。

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