多层螺旋CT增强扫描诊断腹膜转移癌的研究进展  

Development in the Research of Contrast Enhanced Multi-Sliced Computed Tomography in the Diagnosis of Peritoneal Carcinomatosis

作　　者：王林伟[1] 梅列军[1] 李雁[1] 

机构地区：[1]武汉大学中南医院肿瘤科/肿瘤生物学行为湖北省重点实验室/湖北省肿瘤医学临床研究中心,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2013年第1期152-156,共5页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:81171396)

摘　　要：腹膜转移癌来源于恶性肿瘤的腹膜腔内转移播散,术前准确评估其播散程度对临床治疗至关重要。多层螺旋CT增强扫描操作简便、扫描快速、空间分辨率高、运动伪影少,已成为最常用的术前影像学检查措施。腹膜转移癌主要CT征象有腹腔积液、腹膜增厚并强化、网膜侵犯征象及肠管侵犯征象等;可根据术中腹膜转移癌指数评估的原则,采用CT评估腹膜转移癌的播散程度,选择适宜手术的患者;影响腹膜转移癌诊断的因素主要有CT设备的性能和技术、肿瘤直径、肿瘤部位及影像医生的诊断水平。需重视对小肿瘤(<5 mm)和特殊部位肿瘤的检查,以提高腹膜转移癌的检测率。Peritoneal carcinomatosis （PC） is derived from metastatic dissemination of malignant cancer in the peritoneal cavity. Precise preoperative evaluation of the PC status is very important for clinical treatment. Among the current preoperative diagnosis modalities, contrast-enhanced multi-sliced computed tomography （MSCT） has unique advantages because of its availability, simplicity, high-speed, good space resolution, and less movement artifacts. Based on thorough literature study of current MSCT researches, this review is focused on the CT signs, CT-based peritoneal carcinomatosis index （PCI） evaluation, and major impact factors on CT diagnosis. The CT signs of PC are ascites, peritoneal thickening and enhancement, and involving signs of greater omentum and bowel. According to the principle of PCI, CT can predict the extent of PC to choose appropriate patients to receive surgery. Major factors affecting CT diagnosis are technical properties of CT equipment, tumor size and location of the PC, and the experience and knowledge of the radiologist. More attention should be paid to the tumors 〈5 mm and the tumor nodules in special regions in order to improve diagnosis.

关 键 词：腹膜转移癌 多层螺旋CT 腹膜癌评分指数 

分 类 号：R445.3[医药卫生—影像医学与核医学]