腹膜假性黏液瘤的CT和MRI征象分析

CT and MRI features of pseudomyxoma peritonei

目的探讨腹膜假性黏液瘤(PMP)的CT和MRI表现,以提高对本病的诊断及鉴别诊断水平。方法收集我院自2006年1月-2013年6月经手术、病理证实16例PMP患者,结合文献报道,回顾性分析患者的CT、MRI影像学表现。结果 16例中,12例原发病变为阑尾、卵巢病变,4例为结肠病灶。CT、MRI检查能很好地显示PMP病变的分布范围,CT、MRI检查均呈分房状、囊实性改变,改变体位无流动现象,增强扫描囊壁、网膜及腹膜轻度强化。部分病例可见肝、脾外缘"扇贝形"压迹,当肿瘤广泛浸润腹膜、网膜,甚至与脏器粘连形成"冰冻腹"时,腹膜、大小网膜增厚呈饼状。结论 CT、MRI特征性表现有助于PMP的准确诊断,对术前评估具有重要价值。

Objective To investigate the imaging features of pseudomyxoma peritonei(PMP) on CT and MRI, and to improve the diagnosis and differential diagnosis of this disease. Methods Methods A total of 16 cases of PMP were confirmed by operation and pathological examination in our hospital from January 2006 to June 2013. Combining literatures, the CT and MRI images of 16 patients were analyzed retrospectively. Results Among 16 patients, there were 12 cases with primary ovarian and appendix tumors, 4 cases with colon lesions. CT and MRI examinations had a good indication of the distribution range of PMP lesions. CT and MRI displayed lamellar and septate cystic change, without flow phenomena when changes in position. Enhancement scanning showed multilocular solid and cystic lesions with slight enhancement on cyst wall, omentum and peritoneum. The boundary of liver and spleen displayed scalloping. When the tumor extensively infiltrated peritoneum and omentum, even adhesion formation as 'frozen abdomen', peritoneum and omentum were as thick as pie. Conclusion The imaging features of PMP on CT and MRI are very valuable in accurate diagnosis of PMP and preoperative evaluation.