腹膜假性黏液瘤影像学特征及其与EMA关系的研究

Imaging Features of Pseudomyxoma Peritonei and the Relationship with EMA

目的通过分析腹膜假性黏液瘤(PMP)的影像学特征,探讨其与上皮膜抗原(EMA)的关系。方法回顾性分析经病理证实的19例PMP患者临床资料,分析其影像学特征及其与免疫组织化学EMA的关系。结果 19例中原发瘤为卵巢黏液囊腺癌5例,阑尾黏液囊腺癌3例,结肠黏液腺癌1例,胰腺黏液腺癌1例;阑尾黏液囊肿2例,阑尾黏液囊腺瘤2例,卵巢黏液囊肿1例,卵巢黏液性囊腺瘤3例;原因不明者1例。13例行CT检查,5例行CT和MRI检查,1例仅行MRI检查。所有病例均行平扫和增强扫描。所有病灶表现为网膜、肝脾周围、肠间多发黏液,12例肝、脾周围呈"扇贝"样改变;4例腹膜、网膜弥漫性不规则增厚呈饼状,肠管受压向中间聚拢,走行僵硬。13例含有纤维分隔。12例"扇贝征"病例中EMA阳性占11例,EMA的阳性组与阴性组在"扇贝征"差异方面具有统计学意义。结论 PMP影像学具有一定的特征性,"扇贝征"与EMA具有一定的相关性。

Objective To investigate the imaging features of pseudomyxoma peritonei(PMP),and the relationship between PMP and epithelial membrane antigen(EMA)was analyzed. Methods A total of 19 cases of PMP were confirmed by operation or pathological examination in our hospital. The imaging findings and the relationship with its immunohistochemistry characteristics:EMA were analyzed retrospectively. Results 5 mucinous cystadenocarcinoma of ovary,3 appendiceal mucinous cystadenocarcinoma,1 colonic mucinous adenocarcinoma and 1 mucinous pancreatic cystadenocarcinoma,2 appendiceal mucinous cysts,2 appendiceal mucinous cystadenomas,1 ovarian mucinous cyst,3 ovarian mucinous cystadenoma,and 1 unknown cause. 13 patients underwent CT examination,5 patients underwent both CT and MRI examination,and 1 patient underwent only MRI examination. All patients underwent plain and enhanced scan. CT、MRI displayed lamellar and septate cystic change. Scalloping margins appeared in 12 cases. In 4 cases the tumor extensively infiltrated peritoneum and omentum,the diffuse peritoneal and omental thickening showed cake shaped change and the intestine was splayed by pressure. 13 cases had fibrous septation.Amory 12 cases of scalloping sign,11 cases were EMA positive. There was significant difference in scalloping sign between EMA positive and negative group. Conclusion PMP has some special imaging features,and the scalloping margin features have correlation with EMA,and is valuable in accurate diagnosis and preoperative evaluation.