腹膜假性黏液瘤CT诊断(附21例报告)

CT Diagnosis of Pseudomyxoma Peritonei (Report of 21 Cases)

目的：探讨腹膜假性黏液瘤的CT表现，提高对本病的认识。方法：搜集经手术、病理证实的腹膜假性黏液瘤21例，回顾性分析其CT表现。结果：21例中原发瘤恶性8例，其中卵巢黏液囊腺癌3例，阑尾黏液囊腺癌4例，结肠黏液腺癌1例；良性13例，其中阑尾黏液囊腺瘤4例，阑尾黏液囊肿2例，卵巢黏液囊腺瘤6例，胰腺黏液囊腺瘤1例。CT平扫见肝牌等实质脏器边缘扇贝样或结节状压迹，腹腔不规则囊实性肿块，CT值19．9～25．8HU；脏器周围、网膜间隙、腹腔、盆腔见大量黏液性腹水，CT值10～15HU；腹膜增厚，厚度1．0～2．0cm；增强扫描显示囊实性病变仅见囊壁、网膜、腹膜轻度强化，囊内病灶无明显强化。结论：腹膜假性黏液瘤CT表现具有一定的特征，是诊断腹膜假性黏液瘤的重要方法。

Objective： To investigate the CT characteristics of pseudomyxoma peritonei, in order to improve the knowledge of the diagnosis. Methods： Of 21 cases with pseudomyxoma peritonei proved by surgery and pathology, the CT findings were retrospectively analyzed. Results：There were 8 cases with malignant neoplasm,including mucinous cystadenocarcinoma of ovary （n = 3）, appendiceal mucinous cystadenocarcinoma （ n = 4）, colonic mucinous adenocarcinoma （ n = 1 ） ; 13 cases with benign neoplasm, including mucinous cystadenoma of ovary （n= 6）, appendiceal mucinous cystadenoma （n= 4）, appendiceal mucinous cyst and benign pancreatic mucinous cystadenoma （1 case of each）. The CT findings before contrast enhancement were as follows：scallop- and nodule-like indentation of liver and/or spleen surface, irregular intraperitoneal solid-cystic mass with the CT attenuation as 19.9-25.8HU,large amount of mucinous ascites within abdominal, pelvic and omentum cavity with the CT attenuation as 10-15HU, thickening of peritoneum with the thickness as 1-2cm. After contrast administration,mild enhancement of peritoneum,cystic wall and omentum could be revealed. Conclusion： CT characteristics provided important information in the diagnosis of pseudomyxoma peritonei.