【摘要】目的 以卵巢惡性腫瘤為例,探討腹膜轉移瘤的CT表現(xiàn)特征及卵巢惡性腫瘤腹膜轉移的特點。
方法 回顧性分析33例手術切除并經(jīng)病理證實為原發(fā)性卵巢惡性腫瘤,手術后復查有腹膜轉移的CT表現(xiàn)特征,著重觀察和分析病變的部位、數(shù)量、密度和大小。
結果 33例中發(fā)現(xiàn)腹膜轉移病灶186個,復發(fā)病灶10個。最常見的轉移部位是右肝上間隙、右肝下間隙、小腸系膜、胃結腸韌帶、大網(wǎng)膜等。轉移病灶密度以實性為主,病灶直徑在0.5~13 cm之間。
結論 腹膜種植轉移是卵巢惡性腫瘤最常見的轉移方式,常見于右上腹部,尤其是右膈下間隙,腹腔局限性積液也是常見的征象。卵巢惡性腫瘤的術后CT檢查應包括由膈頂?shù)脚璧椎娜繀^(qū)域。
引用本文: 姚晉,閔鵬秋,黃娟. 腹膜轉移瘤的CT征象. 中國普外基礎與臨床雜志, 2005, 12(6): 620-623. doi: 復制
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- 2. Pannu HK, Bristow RE, Montz FJ, et al. Multidetector CT of peritoneal carcinomatosis from ovarian cancer [J]. Radiographics, 2003; 23(3)687.
- 3. Halvorsen RA Jr, Panushka C, Oakley GJ, et al. Intraperitoneal contrast material improves the CT detection of peritoneal metastases [J]. AJR Am J Roentgenol, 1991; 157(1)37.
- 4. Jacquet P, Jelinek JS, Steves MA, et al. Evaluation of computed tomography in patients with peritoneal carcinomatosis [J]. Cancer, 1993; 72(5)1631.
- 5. Coakley FV, Choi PH, Gougoutas CA, et al. Peritoneal metastases: detection with spiral CT in patients with ovarian cancer [J]. Radiology, 2002; 223(2)495.
- 6. Megibow AJ, Bosniak MA, Ho AG, et al. Accuracy of CT in detection of persistent or recurrent ovarian carcinoma: correlation with secondlook laparotomy [J]. Radiology, 1988; 166(2)341.
- 7. Prayer L, Kainz C, Kramer J, et al. CT and MR accuracy in the detection of tumor recurrence in patients treated for ovarian cancer [J]. J Comput Assist Tomogr, 1993; 17(4)626.
- 8. Silverman PM, Osborne M, Dunnick NR, et al. CT prior to secondlook operation in ovarian cancer [J]. AJR Am J Roentgenol, 1988; 150(4)829.
- 9. Meyer JI, Kennedy AW, Friedman R, et al. Ovarian carcinoma: value of CT in predicting success of debulking surgery [J]. AJR Am J Roentgenol, 1995; 165(4)875.
- 10. Johnson RJ. Radiology in the management of ovarian cancer [J]. Clin Radiol, 1993; 48(2)75.
- 11. Kawamoto S, Urban BA, Fishman EK. CT of epithelial ovarian tumors [J]. Radiographics, 1999; 19(Spec No)S85.
- 12. Buy JN, Ghossain MA, Sciot C, et al. Epithelial tumors of the ovary: CT findings and correlation with US [J]. Radiology, 1991; 178(3)811.
- 13. Walkey MM, Friedman AC, Sohotra P, et al. CT manifestations of peritoneal carcinomatosis [J]. AJR Am J Roentgenol, 1988; 150(5)1035.