周围型肺癌干性胸膜转移的多层螺旋CT影像学诊断

BACKGROUND AND OBJECTIVE: 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. METHODS: 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. RESULTS: 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%). CONCLUSION: MSCT has great diagnostic value for peripheral lung cancer with dry pleural dissemination, especially with high accuracy of pleural nodules.