腹膜假性粘液瘤的临床病理与影像表现分析

目的:探讨腹膜假性粘液瘤的临床影像学表现及病理组织学特征,提高对本病的鉴别诊断水平。方法:选取13例经手术及病理证实的腹膜假性粘液瘤,全部病例均行腹部CT检查,分析其两种临床病理分型(良性DPAM和恶性PMCA)的影像学表现。结果:两型腹膜假性粘液瘤有部分共同的CT表现,比如凝胶状腹水、肝脾边缘扇贝形压迹、肠系膜的浸润性改变、实质器官内浸润性病灶,以及腹膜粘液团在两型均可见到,不同的征象在于大量粘液蛋白性腹水和粘液团块中的钙化更多见于DPAM,网膜饼、淋巴结病变、网膜种植性团块以及原发病灶的显示更多见于PMCA。DPAM常常没有网膜饼形成,但常可见典型的肝脏边缘压迹。结论:两型腹膜假性粘液瘤的影像学表现各具有一定的特征性,充分认识其CT征象的不同有利于放射诊断医师作出正确诊断。

Analyzing Study of Clinical Pathology and Imaging Manifestations of Pseudomyxoma Peritonei

Objective:To investigate the imaging findings and pathological characteristics of pseudomyxoma peritonei in order to improve its differential diagnosis. Methods: 13 cases with pseudomyxoma peritonei had proceeded with CT check before operation.All cases were confirmed by operation and pathology.The pathological characteristics (DPAM and PMCA) and imaging findings were analysed.Results:There was considerable overlap in some features of these two types,such as mucinous ascites,hepatic scalloping,parenchymal organ invasion,infiltrative changes in the mesentery and peritoneal nodules,but certain findings deserve consideration.The different features consist in that the presence of large volumes of mucinous ascites and calcification in the masses were more often scen in DPAM while the presence of omental cake,lymphadenopathy,and peritoneal implant or visualization of a primary mass were common in the PMCA.DPAM occurred without the findings of an omental cake and more often with typical hepatic scalloping.Conclusion:Although there is great overlap in CT features between the two categories,still there are some features that are valuable for radiologists to distinguish DPAM from PMCA.