大网膜转移癌的超声诊断探讨种

目的探讨大网膜转移癌的超声诊断价值.方法观察33例经手术或穿刺活检病理证实的大网膜转移癌的二维图像及血流特点.结果①大网膜转移癌可见网膜弥漫性增厚和局限性增厚,以局限性增厚为主(72.7%),主要位于上腹部、右侧腹、左侧腹;②内部回声呈中等回声者23例,其中12例伴低回声结节,呈低回声者10例,4例伴结节;③彩色血流显示率2级以上为60.6%;④33例大网膜转移癌同时伴网膜外转移的占27.3%.结论超声检查大网膜是发现腹腔脏器恶性肿瘤有无腹腔转移的最直接、最敏感的方法.     

大网膜转移癌的超声诊断探讨

目的：探讨大网膜转移癌的超声诊断价值。方法：观察33例经手术或穿刺活检病理证实的大网膜转移癌的二维图像及血流特点。结果：（1）大网膜转移癌可见网膜弥漫性增厚和局限性增厚，以局限性增厚为主（72．7％），主要位于上腹部，右侧腹，左侧腹；（2）内部回声呈中等回声者23例，其中12例伴低回声结节，呈低回声者10例，4例伴结节；（3）彩色血流显示率2级以上为60．6％；（4）33例大网膜转移癌同时伴网膜外转移的占27．3％。结论：超声检查大网膜是发现腹腔脏器恶性肿瘤有无腹腔转移的最直接，最敏感的方法。     

双频超声对大网膜结核的诊断价值

目的 :探讨大网膜结核的声像图表现 ,以提高结核性腹膜炎的超声诊断水平。方法 :用低频和高频超声对 43例经病理证实的大网膜结核患者网膜回声特点进行观察。结果 :1.大网膜结核内部回声可以分为 3种类型 :高回声型、高低回声间杂型 (高频超声呈“大脑沟回”状 )、结节型 ,其中“大脑沟回”状改变为大网膜结核的特征性声像图表现 ;2 .对大网膜病变内部回声的观察 ,高频超声明显优于低频超声。结论 :高频超声检查有助于大网膜结核的诊断     

超声对大网膜良恶性病变的诊断价值

目的探讨超声对大网膜良恶性病变的诊断价值。方法观察62例大网膜增厚患者的超声表现,与超声引导下穿刺活检结果进行对比分析。结果 62例患者中,结核性腹膜炎36例,腹膜假性黏液瘤5例,转移性腺癌18例,恶性间皮瘤2例,非霍奇金淋巴瘤1例。增厚大网膜良性病变表现以高回声、块状增厚及0级血流为主,恶性病变以低回声、结节状及Ⅲ级血流为主,二者比较差异均有统计学意义(P﹤0.05)。结论大网膜良恶性病变声像图特点存在明显差异,超声检查有助于二者的鉴别诊断,具有重要临床价值。     

大网膜病变的超声表现

目的评价大网膜病变的超声诊断价值。积累大网膜病变的超声诊断经验。 方法回顾性分析经病理学证实或临床治疗观察确诊的152例大网膜病变的超声改变。 结果病变大网膜的声像图特征：急性炎症多表现为增厚大网膜边缘锐利、清晰,内部回声略增强,原发性炎症仅与壁层腹膜粘连,继发性炎症邻近原发病灶。原发性肿瘤多表现为椭圆形或分叶状不均匀低回声肿块。结核性增厚的大网膜多呈饼状,回声高低间杂。转移性大网膜增厚多呈不规则结节状,回声中等或较低,并伴有低回声结节,CDFI能显示结节内血流信号。 结论超声医师能够根据大网膜改变的声像图特点,判定大部分病变的性质。当不能确定时,可在超声引导下穿刺活检确认。     

常规超声及弹性成像在大网膜疾病中的应用现状

大网膜是人体内最大的腹膜皱襞,常被其他部位病变所累及,其临床表现缺乏特异性,明确诊断有助于临床制定下一步的诊疗计划。超声作为一种简便、无创、有效的检查方法,可作为大网膜病变的首选影像学检查手段。随着超声弹性成像技术的应用,其在术前对大网膜病变良恶性的诊断有较高的敏感性和特异性。大网膜病变确诊依赖病理检查,而超声引导下大网膜穿刺活检是一种创伤小且有效率高的取材方法,可作为获取病理组织的首选方法。本文对常规超声及弹性成像在大网膜疾病中的应用现状进行综述。     

大网膜恶性肿瘤的超声诊断研究

目的探讨超声诊断大网膜恶性肿瘤的价值。方法回顾性分析25例大网膜恶性肿瘤的超声表现,并与CT表现、病理结果对比分析。结果超声检查18/25例(72%)发现病变,6/25例(24%)未发现病变,误诊1/25例(4%);大网膜恶性肿瘤的超声表现分为三类:巨大实性、囊实性、多发实性小结节。结论超声对判断网膜恶性肿瘤的部位及内部结构具有重要价值,超声声像图复杂多变,判断性质需结合临床和CT等其他影像手段。     

原发性卵巢癌大网膜转移的超声诊断及与CA125的关系

目的 探讨超声检查对原发性卵巢癌大网膜转移的术前诊断价值,并分析其与CA125的关系.方法 分析45例经手术病理或网膜穿刺活检证实的原发性卵巢癌患者,总结其超声、CT及术前CA125值资料并比较.结果 45例原发性卵巢癌患者发生大网膜转移者28例,超声发现23例,准确率为88.9%,敏感度为82.1%,特异度为100%,其与CT检查对原发性卵巢癌大网膜转移有相同的诊断价值;大网膜转移者CA125值较无转移者高.结论 超声对诊断原发性卵巢癌大网膜转移有重要价值,大网膜转移与否与CA125值有一定关系.     

高频超声诊断小儿腹股沟疝大网膜嵌顿伴化脓的价值

目的探讨高频超声对小儿腹股沟疝大网膜嵌顿伴化脓的诊断价值。方法回顾性分析经临床手术及病理证实的13例小儿腹股沟疝大网膜嵌顿伴化脓的声像图表现，并对其伴随的睾丸及其他并发症进行总结分析。结果误诊1例，其余12例的声像图特点为疝囊内不均质中强回声区内见多个不规则、大小不等的无回声区，可呈网格状，通过疝囊颈与腹腔相通。中强回声及无回声区内均未见血流信号。13例中12例伴有1种或多种并发症。结论小儿腹股沟疝大网膜嵌顿伴化脓具有特征性的声像图表现，高频超声可作出正确诊断，同时可检出睾丸情况及其他并发症。     

多排螺旋CT诊断小网膜囊病变的价值

目的 探讨小网膜囊正常解剖及病变的多排螺旋CT（MDCT）表现,评价小网膜囊病变的CT 诊断价值.方法 对24 例小网膜囊病变进行上腹部CT 平扫及三期增强扫描检查,均经手术病理证实.结果 小网膜囊病变中：原发肿瘤6 例（神经鞘瘤2 例,平滑肌瘤1 例,血管瘤1 例,脂肪肉瘤1 例,淋巴瘤1 例）,CT 表现为小网膜囊内边界清晰肿块.邻近脏器的良、恶性肿瘤8 例（胰头癌4 例,肝左叶肝细胞癌2 例,胃间质瘤2 例）,CT 表现为小网膜囊肿块与邻近相应肿瘤边界不清.转移性肿瘤2 例.结核1 例,CT 表现多个病灶融合,内见钙化.积液（腹水漏出液、炎性渗出液、脓液、血液、胆汁、淋巴液）6 例;假性囊肿1 例;CT 均表现为小网膜囊内液性密度灶.结论 多排螺旋CT对小网膜囊病变具有重要的诊断价值.     

超声检查对甲状腺癌术后颈淋巴结转移的诊断价值

目的探讨超声对甲状腺癌术后颈部肿大淋巴结的鉴别诊断价值。方法回顾性分析40例甲状腺癌术后患者颈部淋巴结的超声表现 ,比较转移性淋巴结和非转移性淋巴结在二维超声和彩色多普勒超声的表现 ,以及阳性淋巴结与原发病灶的位置关系。结果67枚转移性淋巴结中 ,沙粒样钙化点出现率为67.16% (45/67) ,周边缺损率为41.79 %(28/67) ,外周长入血管支数>2支的占77.61 %(52/67) ,26枚非转移性淋巴结中 ,沙粒样钙化点出现率为3.85% (1/26) ,周边缺损率为7.69 %(2/26) ,外周长入血管支数>2支的占7.69%(2/26)。转移性淋巴结中有38.81% (26/67)出现在第III群 ,有25.37 %(17/67)出现在第IV群。结论高频超声对甲状腺术后颈部肿大淋巴结的诊断和鉴别诊断具有重要价值。     

Lymphocyte and macrophage infiltration in omental metastases indicates poor prognosis in advance stage epithelial ovarian cancer

ObjectiveTo investigate the prognostic value of immune cells within omental metastases originating from advanced epithelial ovarian cancer (EOC).MethodsWe performed immunohistochemical analysis to determine the levels of CD4+/CD8+ tumor-infiltrating lymphocytes (TILs) and CD68+ tumor-associated microphages (TAMs) in omental specimens from 100 patients with advanced EOC. Significant prognostic factors, including immune cells and clinical parameters, were assessed by Kaplan–Meier survival analysis and Cox models.ResultsCox regression analysis showed that elevated levels of CD68+ TAMs and intra-islet CD4+ TILs in omental metastases were the main risk factors associated with worse survival outcomes for advanced EOC. Moreover, the survival analysis of relationships between omental immune cells and favorable clinical predictors revealed additional prognostic stratification information.ConclusionOmental immune cells (TAMs and TILs) provide alternative prognostic factors in advanced EOC. In contrast to markers of the EOC tumor microenvironment at the primary site, elevated CD68+ TAMs and intra-islet CD4+ TILs in omental metastases serve as negative prognostic markers in advanced EOC and imply an unfavorable outcome.     

超声诊断卵巢癌腹膜及大网膜转移

目的 探讨卵巢癌腹膜及大网膜转移的超声诊断价值.方法 对32例临床诊断卵巢癌患者术前行超声检查,观察其有无腹膜及大网膜转移.结果 术中发现28例腹膜转移,术前超声检出23例(82.14%);术中发现19例大网膜种植转移,术前超声检出15例(78.94%).卵巢癌腹膜转移的声像图特征为腹膜不均匀增厚,可见结节样病灶.大网膜转移灶超声声像图表现为实性回声、囊实混合性回声、腹腔内孤立或散在多发实性小结节.结论 术前超声可对卵巢癌有否腹膜及大网膜转移进行预测.     

Successful laparoscopic extirpation of a large omental lipoblastoma in a child

Omental lipoblastoma is extremely rare among benign tumors. We herein report the case of a child who underwent laparoscopic extirpation of a large omental lipoblastoma. A 4‐year‐old girl was diagnosed with an intra‐abdominal solid tumor. Abdominal imaging revealed a fat density mass that was well encapsulated and measured 18 × 15 × 7.5 cm in size. Considering the MRI findings and movability of the tumor, we strongly suspected that the lesion was an omental lipoblastoma. We initially decided to perform laparoscopic exploration and, if possible, extirpation of the solid tumor sequentially. A total of five trocars were used, and the tumor was found to originate from the omentum. We successfully performed complete resection of the tumor laparoscopically. A histological examination revealed lipoblastoma. For large abdominal tumors in children, the laparoscopic approach is recommended as the first procedure when the tumor is preoperatively considered to be benign and resectable.     

Non‐operative management of primary omental torsion,a case report and literature review

Primary omental torsion is a rare cause of acute abdomen especially in obese patients with inconsistent history, examination, and laboratory findings. The liberal use of computed tomography in casualties has increased its preoperative diagnosis. Despite the controversy, the non‐operative approach should be attempted as a first line of management while the laparoscopic resection should be only considered after failure of non‐operative management.     

Laparoscopic treatment of primary omental torsion: Case report and literature review

Omental torsion is a rare cause of acute abdominal pain. The diagnosis is rarely made preoperatively. The treatment has been classically open. We present a case of omental torsion laparoscopically. A 63‐year‐old man was admitted to the emergency department. The patient had a right upper quadrant pain that started 3 d before his admission. The omentum was freed in a blunt fashion by identifying a point of torsion in the base of the mass. Partial omentectomy was performed with the assistance of a harmonic scalpel. The specimen was retrieved in a bag through a 3 cm left flank incision extended from a 10 mm port site. The pathology evaluation revealed an infarcted omentum. The patient had instant relief of pain, and the recovery was uneventful, with the patient beings discharged 2 d postoperative. The laparoscopic treatment of omental torsion is a safe, feasible and effective alternative.     

Peritoneal ovarian metastases simulating liver parenchymal metastases

Ovarian carcinoma frequently metastasizes to the peritoneum, both locally in the pelvis and elsewhere. Computed tomography (CT) has a limited ability to identify peritoneal implants with a diameter of 2 cm or less. Three cases of subphrenic, diaphragmatic peritoneal implants, preoperatively at CT thought to represent liver parenchymal metastases, are presented. The difficulty in the differentiation of diaphragmatic peritoneal implants from metastases to the capsule and parenchyma of the liver is discussed. To achieve a radical liver resection in patients with ovarian carcinoma, metastatic peritoneal implants must be excluded during operation.