LI Wenbin,JI Xiaowei,Cai Mengting, et al. The value of CT diagnosis in three kinds of pleural thickening lesions[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2018, 48(6): 446-449.
Abstract：Objective: To explore the value of CT in the diagnosis and differential diagnosis of tuberculous pleurisy (TP), metastatic pleural disease (MPD) and malignant pleural mesothelioma (MPM). Methods: The CT images of 143 patients with pleural thickening (TP 95, MPD 31, MPM 17) proved pathologically were reviewed retrospectively in the First Affiliated Hospital of Wenzhou Medical University from January 2008 to April 2017. Combined with CT imaging data, imaging features of each disease were analyzed, and the significance of differential diagnosis was discussed. Results: In patients with TP, the most common features were male, local, smooth and non-circumferential pleural thickening, homogenous enhancement, no mediastinal pleural involvement with lymph node enlargement. Female, diffuse, irregular, nodular, non-circumferential pleural thickening, homogenous enhancement and mediastinal pleural involvement without lymph node enlargement were more frequently seen in MPD group. Female, diffuse, nodular non-circumferential pleural thickening, pleural based mass, inhomogeneous enhancement, no mediastinal pleural involvement and lymph node enlargement were more frequently seen in MPM group. TP group was younger than MPD group and MPM group. The maximal pleura thickness of TP group was shorter than that of MPD group, which was even shorter than that of MPM group. Conclusion: Age, sex, maximum pleural thickness, lesion range, shape, style, enhancement pattern, mediastinal pleural involvement and lymph node enlargement were factors of significance in differentiating tuberculous pleurisy, pleural metastases and malignant pleural mesothelioma.
