腹膜假性黏液瘤多层螺旋CT表现及鉴别诊断  

Multi-slice spiral CT manifestations and differential diagnosis of pseudomyxoma peritonei

作　　者：蒲红[1] 刘登平[1] 王娜[1] 彭泽华[1] 白林[1] 陈加源[1] 蒋瑾[1] 

机构地区：[1]四川省医学科学院四川省人民医院CT室,四川成都610072

出　　处：《实用放射学杂志》2013年第3期423-425,442,共4页Journal of Practical Radiology

摘　　要：目的 探讨腹膜假性黏液瘤的多层螺旋CT表现及鉴别诊断，提高对本病的认识。方法 收集本院经手术及病理证实的腹膜假性黏液瘤病例12例，全部病例术前均行腹部多层螺旋CT扫描，回顾分析其CT影像表现。结果 12例中，11例原发病变为阑尾及卵巢病变，1例为结肠病变。CT表现包括：（1）腹水，密度较高，其内密度不均匀，可见线条状分隔，有8例。（2）腹、盆腔脏器边缘扇贝形或结节状压迹改变，轮廓清楚，相邻脏器无直接侵犯，有8例。（3）腹腔、盆腔内囊状团块影：其内密度均匀，CT值高于水，增强后有边缘强化，其内也可见分隔，囊壁厚度一致或不均，有4例。（4）大网膜、肠系膜、腹膜浸润性改变：表现为弥漫性不规则增厚，呈网状、结节状，局部出现网膜饼，相邻肠管受压移位，有6例。（5）部分病灶可见斑点状、结节状钙化，有3例。（6）原发灶改变：4例见阑尾或卵巢区域囊实性肿块影。结论 腹膜假性黏液瘤具有一定的CT表现特征，CT检查对腹膜假性黏液瘤有重要的诊断及鉴别诊断价值。Objective To investigate the CT manifestations of pseudomyxoma peritonei and raise the diagnosis and differential diagnosis of this disease. Methods 12 cases of pseudomyxoma peritonei confirmed by surgery and pathology were collected. Enhanced scans were performed in twelve patients by multi-slice spiral CT before operation. The CT manifestations were reviewed and analyzed. Results In 12 cases, the lesion of ovarian and appendix were main primary lesion in 11 cases, the lesion of colon in 1 case. CT manifestations including：（ 1）①ascites were found in 8 cases which density was slightly higher than water, and uniformity,with line compartmentation;②abdominal cavity, pelvic organs peripheral scallopings were seen in 8 cases,which outline was clear,and the organs were not encroached straightly;③ the cystiform masses in the celiac and pelvic were demonstrated in 4 cases,which density was uniformity and slightly higher than water,with the edge enhancement after enhanced , and the wall thickness was uniform or heterogeneous;④infihrative changes in the mesentery and omentum and peritoneum were seen in 6 cases which manifestated diffuse irregular thickening with a reticulation or node or pie lesson, adjacent bowel compression and displacement ;⑤spot or node calcifications in the local of lesion were appeared in 3 cases;⑥the lesions of cystiform and mass in ovarian and appendix were found in 4 cases. Conclusion On CT examination, this lesion have some features, which is very valuable to the diagnosis and differential diagnosis of pseudomyxoma peritonei.

关 键 词：假性黏液瘤 腹膜 计算机体层成像 

分 类 号：R735.5[医药卫生—肿瘤] R814.42[医药卫生—临床医学]