CT诊断腹膜腔转移性肿瘤的临床意义

CT diagnosis of metastatic tumor of peritoneum

目的 :探讨腹膜腔转移性肿瘤的CT表现 ,为临床提供有价值的诊治信息。方法 :回顾性分析 2 6例有完整病史资料及手术、病理证实的腹膜腔转移性肿瘤 ,探讨腹膜腔转移性肿瘤的CT表现。结果 :2 6例腹膜腔转移性肿瘤的CT表现为 :①腹水 2 4例 ;②腹膜形态改变 :壁层腹膜不规则增厚 9例 ,呈结节状增厚 5例 ,宽带状 4例 ,块状 3例 ,网膜及肠系膜呈污垢状改变最多见 ( 2 0例 ) ,其次为“网膜饼”征改变 ( 10例 ) ,呈结节状较少见 ( 6例 ) ,但以上改变常混合出现 ;③腹膜病变在腹膜腔的分布 :位于结肠、胃与前腹壁间隙 19例 ,大小肠浆膜面 14例 ,左右膈下隐窝 10例 ,膀胱直肠间隙 7例。结论 :腹膜腔转移性肿瘤CT上常表现为腹水和腹膜形态的改变。全腹CT增强检查结合临床可确定腹膜腔转移性肿瘤的扩散范围 。

Objective:To study the CT appearances of peritoneal metastasis.Methods:26 cases with peritoneal metastasis examined by CT with complete clinical informations and surgical pathological results were retrospectively analyzed. Results:The CT findings of peritoneal metastasis were:①ascites (24 cases).②changes of form and thickness of peritoneum: irregular thickening of the parietal peritoneum (9 cases),nodular changes (5 cases),broad band like thickening (4 cases),cake form (3 cases).The changes of omentum and mesenterium:smudge like appearance (20 cases),cake form (10 cases)and nodular (6 cases).3. The distribution of the lesions:in the space between the colon and stomach and anterior periatoneal wall (19 cases),at the serous surface of the intestine (14),subphrenic space (10) and space between the bladder and rectum (7).Conclusion:Ascites and the changes of form and thickness of peritoneum are the most common CT appearances of peritoneal metastasis.The contrast enhanced CT examination of the abdomen can provide important information about the diagnosis and treatment planning of metastatic tumor of peritoneum.