腹膜假性粘液癌的CT诊断

CT Diagnosis of Peritoneal Mucinous Adenocarcinoma

【目的】探讨腹膜假性粘液癌（PMCA）的CT影像学表现。【方法】回顾性分析经手术病理证实4例PMCA，其原发病灶为胃粘液癌、胆管粘液腺癌、阑尾高分化粘液腺癌和卵巢粘液囊腺癌各1例。【结果】4例发现原发病变，3例CT盆、腹腔粘液性腹水，显示斗篷征和扇贝征。3例腹膜和（或）网膜增厚、网膜饼形成，2例右膈下腹壁结节，1例病灶见钙化灶。【结论】盆腹腔脏器原发肿瘤病灶出现斗篷征和扇贝征，并发腹膜的增厚、腹膜结节和强化、肠道系膜的浸润，有助于PMCA诊断。

[Objective]To explore the C.T findings of peritoneal mucinous adenocarcinoma（PMCA）. [Methods]Four cases pathologically confirmed PMCA were analyzed retrospectively. All patients included gastric mucinous adenocarcinoma, bile duct mucinous adenocarcinoma, appendiceal well-differentiated mucinous adenocarcinoma and ovary mucinous cystadenocarcinoma with one in each. [Results] All 4 patients had the primary affection. Among all patients, 3 patients had pelvic and abdominal mucinous ascites which represented mantle and scalloping signs shown by CT scan. Three patients had the thickening of peritonaeum and omentum and the formation of omentum cake. Two patients had right subdiaphragmatic space nodule. Calcification was found in one case. [Conclusion]The primary tumor lesion in pelvic and abdominal cavity represents mantle and scalloping signs, and is accompanied by the thickening of peritonaeum, peritoneal nodule and calcification, and the infiltrating of mesenterium which are helpful for the diagnosis of PMCA.