Tuengerthal S
Röntgenabteilung, Klinik für Thoraxerkrankungen der LVA Baden, Heidelberg.
Langenbecks Arch Chir. 1987;372:769-77. doi: 10.1007/BF01297929.
In patients with chestwall tumors conventional radiography is most often the next diagnostic step for differentiation and staging. Plain chest films, taken according to ILO-80 regulations, fluoroscopy and x-rays of the bony structures of the thorax are basic examinations. Diagnostic features are intra- and extrathoracic soft tissue masses and/or disturbances of normal fat pads. CT and/or MR are superior for analyzing soft tissue masses and cannot be missed. But bone lesions are better to analyze on conventional x-rays. Skeletal scintigraphy helps to increase the effectivity and is requested before tomography. Invasive diagnostic procedures (phlebography, arteriography, myelography, bronchography) should be performed only after CT- or MR-examinations. They can add important diagnostic details. Selective arteriography enables the radiologist to embolize vessels of large tumors preoperatively, reducing surgical risks, or may be helpful in patients with non-resectable tumors.
对于胸壁肿瘤患者，传统放射照相术通常是下一步用于鉴别诊断和分期的诊断手段。按照国际劳工组织（ILO）-80规定拍摄的胸部平片、荧光透视以及胸部骨骼结构的X线检查是基本检查项目。诊断特征包括胸内和胸外软组织肿块以及/或者正常脂肪垫的紊乱。CT和/或磁共振成像（MR）在分析软组织肿块方面更具优势，不可或缺。但是骨病变在传统X线片上分析效果更佳。骨闪烁显像有助于提高诊断效率，在断层扫描之前要求进行此项检查。侵入性诊断程序（静脉造影、动脉造影、脊髓造影、支气管造影）仅应在CT或MR检查之后进行。它们可以补充重要的诊断细节。选择性动脉造影使放射科医生能够在术前栓塞大型肿瘤的血管，降低手术风险，或者对不可切除肿瘤的患者可能有所帮助。
