PET-CT对腹膜假性黏液瘤的诊断价值

[目的]探讨正电子发射计算机断层显像(PET-CT)对腹膜假性黏液瘤(PMP)诊断价值.[方法]回顾性分析本院收治的1例经手术证实的PMP患者的PET-CT影像特点,根据其最大18F-FDG标准吸收值(SUV-max)及其影像特点总结其诊断经验.[结果]PET-CT图像显示腹、盆腔内大量水样密度影,CT值范围约15～19HU,未见明显糖代谢增高.SUVmax为0.86,增强扫描“腹水”未见明显异常强化;改变体位(右侧卧位)检查腹腔内水样密度影形态变化不明显,腹腔肠管未见明显活动;肝脏边缘呈扇贝形受压,肠管受压、内移;网膜、肠系膜未见明显增厚,腹腔内未见明显肿大淋巴结,综上考虑为PMP可能性大,术后病理证实为低级别PMP.[结论]PMP较罕见,PET-CT对该病有较好的诊断价值.     

患者自组织互助网站设计与发展探析

介绍由民间自发建立的“中国腹膜假性黏液瘤网络互助联盟”网站构建的必要性、目的与意义,从界面策划、前后台技术开发、内容、结构等方面阐述网站建设基本思路,最后探讨其发展现状及应用效果。     

腹膜假粘液瘤影像诊断价值(附25例分析)

目的:探讨腹膜假性粘液瘤的影像表现及对本病的诊断价值。方法:回顾性分析25例经手术及病理证实病例的影像表现。结果:腹膜假性粘液瘤有以下影像表现:①腹腔弥漫积液(25/25),肝、脾边缘病灶CT值明显高于腹盆腔病灶;②肝、脾边缘"扇贝样"压迹(25/25);③腹、盆腔散在点状、不规则索条状钙化灶(18/25);④可肝(2/25)、脾(10/25)转移,脾脏转移多见;⑤腹膜后不受累及(25/25);⑥磁共振T2WI显示病灶内有多发不规则分隔(2/2)。结论:PMP的影像学检查应以CT检查为首选,结合MR表现,应能大部分准确术前诊断,对累及范围也能准确评估,在PMP患者的复发和病情评估中也有重要价值。     

Perioperative nutritional assessment and interventions in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC): A systematic review

BackgroundPeritoneal carcinomatosis is a catabolic state and cytoreductive surgery (CRS) is a high morbidity operation. Optimising perioperative nutrition is crucial to improve outcomes. This systematic review sought to examine literature describing clinical outcomes related to preoperative nutrition status and nutrition interventions in patients undergoing CRS with hyperthermic intraperitoneal chemotherapy (HIPEC).MethodsA systematic review was registered with PROSPERO (300326). A search of eight electronic databases was undertaken on 8th May 2022 and reported according to the PRISMA statement. Studies reporting nutrition status through use of screening and assessment tools, nutrition interventions or nutrition-related clinical outcomes for patients undergoing CRS with HIPEC were included.ResultsOf 276 screened studies, 25 studies were included for review. Commonly used nutrition assessment tools for CRS-HIPEC patients included Subjective Global Assessment (SGA), sarcopenia assessment with computed tomography, preoperative albumin, and body mass index (BMI). Three retrospective studies compared SGA with postoperative outcomes. Malnourished patients were more likely to have postoperative infectious complications (p = 0.042 SGA-B, p = 0.025 SGA-C). Malnutrition was significantly associated with increased hospital length of stay (LOS) in two studies (p = 0.006, p = 0.02), and with overall survival in another study (p = 0.006). Eight studies analysing preoperative albumin levels reported conflicting associations with postoperative outcomes. BMI in five studies was not associated with morbidity. One study did not support routine nasogastric tube (NGT) feeding.ConclusionsPreoperative nutritional assessment tools, including SGA and objective sarcopaenia measures, have a role in predicting nutritional status for CRS-HIPEC patients. Optimisation of nutrition is important for preventing complications.