恶性腹膜间皮瘤的CT诊断与鉴别  

CT diagnosis and differential diagnosis of malignant peritoneal mesothelioma

作　　者：支秋丽 马周鹏 于骞 王春 朱建忠 ZHI Qiuli;MA Zhoupeng;YU Qian;WANG Chun;ZHU Jianzhong(Department of Radiology,the Affiliated Cixi Hospital of Wenzhou Medical University,Ningbo,Zhejiang Province 315300,China;Department of Radiology,J inshan Branch of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201501,China;Department of Radiology,the Second Affiliated Hospital of Shandong First Medical University,Tai'an,Shandong Province 271000,China)

机构地区：[1]温州医科大学附属慈溪医院放射科,浙江宁波315300 [2]上海中医药大学附属龙华医院金山医院放射科,上海201501 [3]山东第一医科大学第二附属医院放射科,山东泰安271000

出　　处：《实用放射学杂志》2020年第12期1957-1960,共4页Journal of Practical Radiology

基　　金：上海市金山区科委面上项目(2018-3-17)。

摘　　要：目的探讨恶性腹膜间皮瘤(MPM)的CT表现.方法回顾性分析12例经病理学证实MPM的CT资料.结果12例中1例局限型呈腹膜单发厚壁囊性肿块,CT平扫实性成分为等及稍低密度,增强不均匀轻至中度强化.11例弥漫型中1例呈腹腔、腹膜后多发低密度囊性病灶,6例呈腹膜及肠系膜弥漫结节样、饼样增厚,4例呈肠系膜及网膜饼样、污垢样增厚;CT平扫病灶呈等及稍低密度,增强8例不均匀轻至中度强化,3例较明显持续强化.弥漫型见腹内广泛浸润,10例伴有少量腹水,1例肺内转移.结论MPM多为弥漫型,CT呈腹膜及大网膜弥漫性结节状或饼状增厚、肠系膜不规则增厚,增强轻、中度到明显强化,多伴有腹腔浸润及腹水;局限型多表现为不规则囊性肿块,增强轻至中度强化;CT对其诊断和鉴别具有重要价值.Objective To explore the CT manifestations of malignant peritoneal mesothelioma(MPM).Methods The CT data of 12 cases with MPM proved by pathology were analyzed retrospectively.Results Among 12 cases,1 case was localized type which presented as a single cystic mass with thick wall of the peritoneum,and the solid component showed equal and slightly low density on unenhanced CT,and with mild to moderate enhancement on enhanced CT.Among 11 cases of diffuse type,1 case showed multiple cystic lesions of the abdominal cavity and retroperitoneum,6 cases showed diffuse nodular or pie like thickening of the peritoneum and mesentery,4 cases showed pie and fouling like thickening of the mesentery and omentum;and showed equal or slightly low density on unenhanced CT,8 cases showed inhomogeneous mild to moderate enhancement and 3 cases showed obvious enhancement on enhanced CT.Diffuse abdominal infringement occurred in all diffuse type,small amount of ascites was observed in 10 cases,intrapulmonary metastasis occurred in 1 case.Conclusion The most MPM are diffuse type,which show diffuse nodular or pie like thickening of the peritoneum and omentum,irregular thickening mesentery,accompany with infiltration of the abdominal cavity and ascites,and with mild,moderate to obvious enhancement;The limited type is rare and shows irregular mass of the peritoneum and abdominal cavity,with mild to moderate enhancement;CT is of important value for the diagnosis and differential diagnosis of MPM.

关 键 词：腹膜 恶性间皮瘤 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]