腹膜假黏液瘤的CT及MRI表现

目的 分析腹膜假黏液瘤(PMP)的CT及MRI表现。方法 回顾性分析经病理证实的27例PMP, 均接受全腹部CT平扫,其中25例接受增强扫描;7例接受盆腔MR平扫,3例同时接受上腹部MR平扫;观察PMP胶冻样腹腔积液出现的位置及影像学特征。结果 27例均可见不同程度的腹腔积液。22例肝脾周围可见"扇贝样"压迹,23例网膜增厚、呈污垢样改变,15例小肠移位,5例钙化,16例可见纤维分隔。腹腔积液量较少时,右侧结肠旁沟积、膈下间隙及肝周积液量多于左侧结肠旁沟、左侧膈下间隙及脾周;腹腔积液量较多时,均可见"扇贝样"压迹,右、左膈下间隙积液量无明显差异。与CT相比,MRI能更好地显示腹腔内黏液团、纤维分隔及卵巢原发灶。结论 CT及MRI显示肝、脾边缘"扇贝样"压迹、网膜及肠系膜增厚、小肠移位、腹腔积液中见纤维分隔或包裹等征象对诊断PMP具有一定价值。

CT and MRI features of pseudomyxoma peritonei

Objective To observe CT and MRI features of pseudomyxoma peritonei (PMP). Methods The imaging appearances of 27 patients with PMP proved by histopathology were analyzed retrospectively. All patients underwent whole abdominal plain CT, while 25 of them underwent enhanced CT scan. Seven patients underwent plain MR scan of pelvic, 3 of them underwent plain MR scan of upper abdomen and the pelvis at the same time. The imaging features and the location of the mucinous ascites were observed. Results Various volume of mucinous ascites were found in 27 patients. The scalloping margins were detected in 22 patients, and peritoneum thickening was found in 23 patients. Fifteen patients had unilateral or concentric small bowels displacement. Calcifications were detected in 5 patients, and fibrous septa in 16 patients. When the volume of mucinous ascites was relatively small, the lesions in the right subphrenic space and surface of the liver was more than that in the left subphrenic space and surface of the spleen. However, when the volume of mucinous ascites was relatively large, no obvious difference was revealed within right and left subphrenic space. Compared with CT, MRI could show mucous groups, fibrous septa and ovarian primary tumor more clearly. Conclusion CT and MRI manifestations, such as scalloping margins of peri-hepatic and peri-splenic, peritoneum thickening, small bowl displacement and the mucous groups, as well as fibrous septa in the mucinous ascites have some reference value for diagnosis of PMP.