应用胃肠道碘水造影对腹膜转移癌的术前评估  

Preoperative Evaluation of Peritoneal Carcinomatosis with Gastroenterography

作　　者：梅列军[1,2] 刘俊方[1] 李雁[2] 唐利[2] 刘少平[2] 

机构地区：[1]武汉大学中南医院放射科,湖北武汉430071 [2]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6期875-878,共4页Medical Journal of Wuhan University

基　　金：教育部博士点专项研究基金(编号:20120141110042);湖北省自然科学基金(编号:2012FFB04314)

摘　　要：目的:评估细胞减灭术加腹腔热灌注化疗术前腹膜转移癌(PC)患者的肠管蠕动状况、肠系膜浸润程度。方法:根据血清CA125、CA199及CEA指标和多层螺旋CT增强加多平面重建技术,确诊PC 30例,原发病变包括胃癌、结直肠癌、卵巢癌、腹膜假性黏液腺瘤、阑尾恶性黏液腺瘤、胆囊癌、肺癌,口服泛影葡胺后,行胃肠道造影检查。结果:30例患者的造影检查显示:10例(30%)局限性肠管受侵,管腔显示稍窄,黏膜变形;3例(10%)小肠系膜明显挛缩,呈球状或花瓣状改变,位置固定,肠管黏膜消失;16例(53.3%)肠管蠕动正常,肠管轻度聚集现象,肠管黏膜平坦;4例(13.3%)小肠系膜无挛缩征象,肠管蠕动正常,分布均匀,肠管黏膜形态正常;与术中所见相近。结论:PC患者术前行胃肠道碘水造影,可全面了解胃肠道蠕动状况及肠系膜浸润程度,指导临床筛选合适的手术病例。Objective： To assess the intestinal peristalsis and mesenteric invasion in patients with perito- neal carcinomatosis （PC） before cytoreductive surgery plus hyperthermic perfusion chemotherapy （CRS＋ HIPEC）. Methods： Thirty cases including gastric cancer, colorectal cancer, overian canc- er, pseudomucinous peritonei adenocarcinoma, appendix mucinous adenocarcinoma, gallbladder cancer, and lung cancer that had been confirmed as peritoneal carcinomatosis according to sero- logical CA125, CA199 and CEA and enhanced multi-detector row contrast-enhance computed tomography （MDCT） plus multiplanar reconstruction technique received gastroenterography after oral gastrografin. Results： The local intestinal canal invasiveness and intestinal stenosis were found in 10 cases; remarkable mesenteriolum contractures with fixed spherical or petal-like chan- ges were found in 3 cases; the intestinal canal showed euperistalsis with mild aggregation in 16 cases. All findings were consistent with the gross anatomy and surgery. Conclusion： Gastroenter- ography would be a helpful screening method for patients with PC before operation, and could fully demonstrate the condition of intestinal canal peristalsis and mesentery invasiveness.

关 键 词：腹膜转移癌 泛影葡胺 胃肠数字X线成像 

分 类 号：R730.4[医药卫生—肿瘤]