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目的分析和总结心包转移瘤的CT表现特征,为早期诊断和治疗提供帮助。方法对37例经临床病理确诊的心包转移瘤的CT图像以及临床资料进行分析。主要观察指标包括:有无心包增厚、心包积液、纵隔淋巴结肿大以及直接侵犯等。结果 32例(86.5%)出现心包积液(其中轻度心包积液有21例,中-重度积液为11例);28例(75.6%)有心包增厚或结节,其中弥漫性不均匀增厚者有15例,厚度为4~7 mm;出现结节或肿块者13例,结节的直径为5~12 mm,其中9例为实性结节、另4例为囊实性结节;15例(40.5%)并纵隔淋巴结肿大(肿大的淋巴结主要分布于隆突下、主肺动脉窗和肺门等处)。共10例直接侵犯心包,表现为心包壁层被突破、肿块突入心包腔。结论心包转移癌在CT上多表现为心包积液、心包增厚、纵隔淋巴结肿大以及心包直接受侵犯等。CT对心包转移癌的诊断及治疗方法选择有帮助,但最终确诊仍需依靠病理学检查。
Objective To analyze and summarize the CT features of pericardial metastases and provide help for early diagnosis and treatment. Methods Thirty-seven cases of pericardial metastatic tumor confirmed by clinical pathology were analyzed with CT images and clinical data. The main observation indicators include: whether pericardial thickening, pericardial effusion, mediastinal lymph nodes and direct violations. Results 32 cases (86.5%) had pericardial effusion (including 21 cases of mild pericardial effusion, 11 cases of moderate-severe effusion); 28 cases (75.6%) had pericardial thickening or nodules, of which diffuse There were 15 cases of uniform thickening, the thickness of 4 ~ 7 mm; nodules or masses in 13 cases, nodules of 5 ~ 12 mm in diameter, of which 9 cases of solid nodules, the other 4 cases of cystic solid Nodules; 15 cases (40.5%) and enlarged mediastinal lymph nodes (enlarged lymph nodes are mainly located in the subglotten, the main pulmonary artery and pulmonary hilar and other places). A total of 10 cases of direct invasion of the pericardium, the performance of the pericardial wall was broken, broke into the pericardial mass. Conclusions Pericardial metastatic carcinoma often manifests as pericardial effusion, pericardial thickening, mediastinal lymph node enlargement and pericardial invasion directly on CT. CT diagnosis of pericardial metastases and treatment options to help, but the final diagnosis still need to rely on pathological examination.