Aquino S L, Webb W R, Gushiken B J
Department of Radiology, University of California, San Francisco 94143-0628.
Radiology. 1994 Sep;192(3):803-8. doi: 10.1148/radiology.192.3.8058951.
To determine the accuracy of computed tomography (CT) in enabling differentiation of pleural exudates from transudates.
Eighty consecutive patients (86 effusions) underwent contrast-enhanced CT. Thoracentesis was performed to measure pleural and serum total protein and lactate dehydrogenase (LDH) values. Effusions were classified as exudates with accepted criteria. CT scans were evaluated for the presence and appearance of parietal pleural and extrapleural fat thickening.
Fifty-nine effusions were exudates and 27 were transudates. Thirty-six of the 59 exudates (61%) were associated with parietal pleural thickening. All cases of empyema and 56% of the parapneumonic exudative effusions had pleural thickening. The specificity of this finding in diagnosing the presence of an exudate is 96%.
Parietal pleural thickening at contrast-enhanced CT almost always indicates the presence of a pleural exudate. A pleural exudate in the absence of pleural thickening occurs most frequently in patients with malignancy or uncomplicated parapneumonic effusion.
确定计算机断层扫描（CT）在鉴别胸腔渗出液和漏出液方面的准确性。
连续80例患者（86处胸腔积液）接受了增强CT检查。进行胸腔穿刺以测量胸腔和血清总蛋白及乳酸脱氢酶（LDH）值。根据公认标准将胸腔积液分类为渗出液。评估CT扫描中胸膜增厚和胸膜外脂肪增厚的情况。
59处胸腔积液为渗出液，27处为漏出液。59例渗出液中有36例（61%）伴有胸膜增厚。所有脓胸病例和56%的肺炎旁渗出性胸腔积液均有胸膜增厚。这一发现对诊断渗出液存在的特异性为96%。
增强CT上的胸膜增厚几乎总是提示胸腔渗出液的存在。无胸膜增厚的胸腔渗出液最常见于恶性肿瘤患者或单纯性肺炎旁胸腔积液患者。
