彩色多普勒超声诊断腹膜假性粘液瘤临床应用

目的探讨彩色多普勒超声在腹膜假性粘液瘤诊断中的价值。材料与方法回顾性分析5例经手术、病理证实的腹膜假性粘液瘤患者声像图特点。结果腹膜假性粘液瘤的图像表现:本组病例均可显示腹、盆腔积液暗区,4例内显示为密集点状回声暗区,2例经超声显示大网膜增厚,彩色多普勒显示2例在增厚网膜上显示少许血流信号,另3例未能显示血流信号。结论腹膜假性粘液瘤的彩色多普勒声像图表现有一定特征性,彩色多普勒超声诊断腹腔假性粘液瘤安全、便捷,可作为腹膜假性粘液瘤的首选检查方法。     

腹膜假性粘液瘤的超声诊断特征

腹膜假性粘液瘤又称腹腔假性粘液瘤⒚本文报道经手术切除和病理证实的５例腹膜假性粘液瘤的超声表现⒚５例中男３例、女２例⒙年龄６０～７７岁⒉平均６８５岁⒕⒚所用仪器为ＡｌｏｋａＳＳＤ６３０⒙探头频率３５ＭＨｚ⒚结果⑶５例患者超声表现腹腔内无数大小不等的液性暗区⒙呈蜂窝状⒉图１⒕⒙并可见弱光点回声和部分肠管及减弱的肠蠕动⒛４例并有腹水征⒚讨论腹膜假性粘液瘤病因尚未清楚⒙以往报道为良性肿瘤⒙而实际上它是一种恶性程度较低的肿瘤〔１⒙２〕⒙主要来源于卵巢的粘液囊腺瘤或囊腺癌和阑尾粘液囊肿⒙这种聚积于腹腔…     

腹膜假性粘液瘤的超声诊断

腹膜假性粘液瘤是临床罕见的疾病，临床表现无特异性，易误诊误治。本文报告我院５例腹膜假性粘液瘤经手术、病理证实，根据声像图资料回顾总结如下。１资料和方法本组５例，男２例，女３例，年龄３６～５２岁。使用GE－２００型超声诊断仪，探头频率３．５MHz，腹部多个切面直接扫查。２结果B超表现：５例腹腔内均为积液，但量的多少及范围均不相同，故声像图表现各异：①提示为腹腔积液１例，液面范围很小只局限于下腹，呈包裹状，暗区内可见散在光点，患者为军人，男性，无任何症状，体检时被发现，后手术病理证实为阑尾粘液瘤破裂；②提示为腹膜结核性腹水待查２例，其中１例为男性，暗区范围大，液性暗区内可见不规则条索样强回声及强回声光点；③提示为腹膜假性粘液瘤２例均为女性，其中１例年龄４３岁，腹部憋胀不适６月余，伴盗汗、纳差、乏力等，当地医院诊断为“结核性腹膜炎”，抗结核治疗症状稍减轻，但腹胀无明显改变，反而渐进加重，来我院就诊时患者腹部膨隆如足月妊娠，腹壁张力大，B超所见：腹腔内各脏器间隙及盆腔、子宫直肠窝可见大量不规则液性暗区，呈“蜂窝状”（图１）。手术病理所见：本组５例，４例在本院手术，术中见腹腔内充满胶冻样粘液物质及大小不等结节状物，质脆...     

腹膜假性粘液瘤的影像诊断(附2例报告)

腹膜假性粘液瘤的影像诊断（附２例报告）张东友①陈常佩②王孝英③腹膜假性粘液瘤（ｐｓｅｕｄｏｍｙｘｏｍａｐｅｒｉｔｏｎｅｉ）又称假性粘液瘤性腹水，或假性腹水，以腹膜腔内充以大量粘蛋白，形成假性腹水为特证。临床上非常罕见，笔者遇到二例，现报导如下：例１女...     

阑尾粘液囊肿的诊治

目的探讨阑尾粘液囊肿及其合并的腹膜假性粘液瘤的诊治。方法收集我院16年来收治的阑尾粘液囊肿9例，对其病理．临床表现．辅助检查及治疗进行回顾性分析。结果所有9例患者中，5例病理证实为阑尾粘液囊肿。2倒为阑尾粘液瘤，其中1例并发腹膜假性粘液瘤。2例阑尾粘液癌，其中1例并发腹膜假性粘液瘤。经随访．除1例固脑溢血死亡外，余8例长期存活。1例阑尾粘液瘤并发腹膜假性粘液瘤术后复发。结论阑尾粘液囊肿有单纯粘液囊肿、粘液囊肿瘤和粘液囊肿癌之分。这三种疾病也是连续变化的过程。后二者可并发腹膜假性粘液瘤。如对这些疾病有充分的认识，术前可以作出正确的诊断并收到良好的治疗效果。     

腹膜假性粘液瘤的现在认识

腹膜假性粘液瘤是一种以粘液外分泌性细胞在腹膜或网膜种植而导致腹腔内大量胶冻状粘液腹水特征的疾病 ,腹膜假性粘液瘤的发病率较低 ,据文献报道 ,每一万次腹部手术中可遇到两例[1 ] 。 1 884年Ｗｅｒｔｈ首次报道一例腹膜假性粘液瘤 ,患者是来源于阑尾囊腺瘤 ,1 90 1年 ,Ｆｒａｎｋｅｌ报道了一例来源于阑尾的囊肿。这些早期病例报道以后 ,关于腹膜假性粘液瘤的文献报道越来越多 ,对其来源的争论也日益激烈。最近通过免疫组织化学和基因学分析的运用 ,通过聚合酶链反应 ,争论得到了解决。1　腹膜假性粘液瘤的病理来源从 1 884年Ｗｅｒｔｈ…     

心脏粘液瘤的超声心动图诊断价值

目的　应用超声心动图观察心脏粘液瘤的声像图特点 ,评价其临床应用价值。方法　对 2 5例经手术证实的心脏粘液瘤病人的超声心动图进行诊断和分析 ,总结其声像图特点和规律。结果　超声心动图可对粘液瘤的好发部位、形态、大小、数目及心脏相关改变作出判断。结论　超声心动图对心脏粘液瘤具有独特的诊断价值 ,是诊断心脏粘液瘤的首选方法。     

腹膜假性粘液瘤MRI表现1例

腹膜假性粘液瘤（Psendomyxoma peritonei,PMP)是一种以粘液外分泌性细胞在腹膜或网膜种植血导致腹腔内大量胶冻状粘液腹水为特征的疾病，发病率很低，笔者收集1例MRI资料，经手术病理证实，现报道如下。     

超声在腹膜假黏液瘤术前病理分级中的应用价值

目的研究腹膜假黏液瘤的声像图特征,分析超声检查在不同病理分级腹膜假黏液瘤诊断中的应用价值。方法术前对62例腹膜假黏液瘤患者进行超声检查,记录临床特点、声像图特征、剖腹术中表现及病理结果,根据术后病理结果,将研究对象分为高级别组及低级别组。对比术中表现分析腹膜假黏液瘤的声像图特征,分析不同级别腹膜假黏液瘤的声像图差异。结果肝脾周围压迹、盆腹腔包块及腹腔肿大淋巴结在两组中具有统计学差异,而是否出现网膜饼在两组中无统计学差异。腹水指数及网膜饼厚度在两组中具有统计学差异。肿瘤标记物CEA、CA125、CA199、CA724和CA242在两组患者中均升高,但两组间差异无统计学意义。结论术前超声检查对腹膜假黏液瘤的诊断具有一定的临床应用价值。不同病理级别腹膜假黏液瘤声像图特征有重叠,但有些声像图特征可以帮助鉴别诊断。     

儿童腹腔器官外囊性病变的超声诊断价值

目的探讨超声对各种腹腔器官外囊性包块的诊断意义。方法回顾性分析经超声检查的44例患儿腹腔器官外囊性病变的声像图特点,并与手术、病理结果对照。结果 44例患儿胃肠重复畸形17例,其中胃重复畸形1例,肠重复畸形16例;梅克尔憩室4例;淋巴管瘤17例,其中大网膜淋巴管瘤4例,肠系膜淋巴管瘤12例,腹膜后淋巴管瘤1例;囊性畸胎瘤3例;胰腺假性囊肿2例;腹腔异物1例。结论超声对儿童腹腔器官外囊性包块的诊断具有重要价值,是术前诊断的首选方法。     

Pseudomyxoma peritonei manifesting as intestinal obstruction

Pseudomyxoma peritonei is an appendiceal tumor with distinct clinical and pathologic features. It frequently presents a problem in diagnosis and management. We report a case of pseudomyxoma peritonei, which initially appeared with intestinal obstruction. This is a rare initial manifestation in patients who have not had multiple surgical procedures. We review the literature and discuss the unique clinical features and misconceptions surrounding pseudomyxoma peritonei.     

腹膜假性黏液瘤的CT影像表现

目的 回顾性分析腹膜假性黏液瘤的CT影像表现,提高对本病的诊断及鉴别诊断水平.方法 选取经手术病理证实的腹膜假性黏液瘤患者8例,其中5例复发,全部病例均行腹部CT扫描检查,分析其CT影像表现.结果 8例患者均见大量腹水,肠管受压移位,在肝脾边缘形成扇贝形压迹,且5例复发病例扇贝形压迹明显;5例有肠系膜浸润性改变,5例见脐疝;4例表现为腹、盆腔内分房黏液团块;3例原发病例腹膜增厚明显,5例复发病例无明显腹膜增厚;腹壁种植2例;1例合并胸水.结论 腹膜假性黏液瘤CT表现具有一定的特征性,故CT检查对腹膜假性黏液瘤有重要的诊断和鉴别诊断价值.     

Gray-scale sonographic findings in a patient with pseudomyxoma peritonei

Pseudomyxoma peritonei is a rare condition in which the abdominal cavity fills with thick mucoid material as a result of either a benign or malignant disease. We report the findings with gray-scale sonography and laparoscopy in a 74-year-old man with pseudomyxoma peritonei. After paracentesis and drainage of the ascites, sonography visualized hypoechoic nodules in the peritoneum at the surface of the liver and between bowel loops. Laparoscopy revealed mucoid material diffusely throughout the abdominal cavity. The diagnosis of pseudomyxoma peritonei was confirmed by cytologic examination of peritoneal fluid and histologic examination of laparoscopically obtained specimens.     

腹膜假黏液瘤的超声诊断(9例报告)

目的　探讨腹膜假黏液瘤超声图像的特点。方法　对 9例手术证实为腹膜假黏液瘤的病例的超声特点进行了分析总结。结果　超声特点主要是 :移动性很小的腹水 ,形态不规则、大小不等的多房性蜂窝状、网格状强回声及腹膜明显增厚。结论　腹部B超是术前诊断腹膜假黏液瘤的一种有价值的检查。     

Incidental ultrasound diagnosis of pseudomyxoma peritonei in an asymptomatic woman.

An incidental finding of pseudomyxoma peritonei is reported in a woman with a 6-month history of postmenopausal bleeding. A transvaginal ultrasound scan revealed a poorly defined echogenic mass in the right iliac fossa above the right ovary and free fluid of mixed echogenicity in the pouch of Douglas. Laparoscopic appendicectomy and aspiration of mucinous fluid was performed without adjuvant chemotherapy. Regular postoperative follow-up scans, which are needed as the disease may have an indolent course, showed no signs of recurrence. The differential diagnosis and management of pseudomyxoma peritonei are discussed.     

Primary mucinous cystadenocarcinoma of the appendix with pseudomyxoma peritonei manifested as a splenic mass

We have reported a case of pseudomyxoma peritonei manifested as a splenic mass in a 38-year-old woman. Upon reviewing previously reported cases of pseudomyxoma peritonei with visceral involvement or extension above the diaphragm, we conclude that such spread of the disease does not significantly alter the prognosis. Furthermore, our findings support the concept that pseudomyxoma peritonei represents the implantation of malignant cells rather than metaplastic transformation of mesothelial cells.     

腹膜假性黏液瘤的B超诊断

目的探讨腹膜假性黏液瘤的B型超声表现特点。方法回顾性分析23例经手术、腹腔穿刺和腹腔镜检查,并经病理检查证实的腹膜假性黏液瘤B型超声表现。结果恶性7例,其中卵巢黏液囊腺癌3例,阑尾黏液囊腺癌3例,结肠黏液腺癌1例;良性16例,其中卵巢黏液囊腺瘤9例,阑尾黏液囊腺瘤4例,阑尾黏液囊肿2例,胰腺黏液囊腺瘤1例。黏液腹腔积液中大量13例,少量10例;17例于腹、盆腔内共见35个直径2.3-31.0 cm的黏液包块;肝脾边缘“扇贝样”压迹7例,肠管受压12例,大网膜呈饼状11例,腹膜增厚17例,囊性包块内见蜂窝状改变6例,网状光带状分隔7例。结论腹膜假性黏液瘤B型超声图像表现具有一定特性,超声诊断PMP具有方便快捷、准确性较高优点。     

Pseudomyxoma peritonei with progressive calcifications: CT findings

Development of abdominal calcifications due to pseudomyxoma peritonei is rare. The authors present three cases whereby computed tomographic (CT) studies during or after chemotherapy for pseudomyxoma peritonei demonstrated development and progression of punctate calcifications in the abdomen. The clinical and CT findings of these cases are presented together with a brief review of the pertinent literature.     

阑尾黏液性囊性病变的超声表现

目的 研究阑尾黏液性囊性病变超声表现,提高诊断准确性.方法 回顾分析16例病理证实阑尾黏液性囊性病变或其腹腔假黏液瘤患者超声资料.结果 阑尾单纯性黏液囊肿1例及囊腺瘤2例:肿块管状或类圆形;囊壁薄光滑;囊内点状均匀回声;1个肿块周围见无回声区;肿块未见血流信号.局限性阑尾黏液性囊腺癌7例:肿块椭圆形、类圆形及欠规则形;...     

Mucinous appendiceal neoplasms: pathologic classification,clinical implications,imaging spectrum and mimics

Abdominal Radiology - Mucinous appendiceal neoplasms are uncommon, but important to recognize with imaging due to malignant potential. Peritoneal seeding and pseudomyxoma peritonei can occur with...