腹膜间皮瘤的CT诊断与鉴别诊断

发布时间：2018-04-17 16:55

本文选题：腹膜 + 腹膜肿瘤　；参考：《临床放射学杂志》2017年09期

【摘要】：目的探讨腹膜间皮瘤(PM)的CT表现及鉴别要点。方法回顾性分析经病理和(或)免疫组织化学证实的18例PM的CT和临床资料。结果 18例PM的CT表现为:(1)恶性PM 13例,其中弥漫型10例,局限型3例;10例弥漫型表现为腹膜、肠系膜及网膜不规则增厚,9例伴腹腔积液;4例腹膜、肠系膜呈肿块状、斑片状增厚,3例肠系膜、网膜呈"饼状"、"污垢状"增厚,3例腹膜呈多发小结节状增厚;6例增强扫描后增厚的腹膜、肠系膜及网膜明显强化;3例局限型表现为腹腔巨大孤立性囊实性肿块,以囊性为主伴壁结节,2例增强后实性成分轻中度强化;(2)良性囊性PM 3例,表现为单囊性或多囊性液性密度肿块,囊壁薄而均匀,2例增强扫描后无强化;(3)高分化乳头状PM 2例,表现为附件区不规则囊实性肿块,1例伴钙化灶及少量盆腔积液,1例增强扫描后实性部分轻中度强化。结论 PM的CT表现多样,恶性者有一定的相对特征性,结合临床资料和鉴别诊断,综合分析,可以提高本病的诊断水平。
[Abstract]:Objective to investigate the CT findings and differential features of peritoneal mesothelioma (PMN).Methods CT and clinical data of 18 cases of PM confirmed by pathology and / or immunohistochemistry were analyzed retrospectively.Results the CT findings of 18 cases of PM were as follows: (1) malignant PM (n = 13), including diffuse type (n = 10), localized type (n = 10), diffuse type (n = 10), irregular thickening of mesentery and omentum (n = 9) with peritoneal effusion (n = 4).The mesenteric membrane was thickened in 3 cases with macular thickening, the omentum was "cake shaped", and the peritoneum was thickened in 3 cases with "fouling" in 3 cases with multiple small nodule thickening in 6 cases with peritoneal thickening after enhanced scanning.In 3 cases of mesenteric and omentum enhancement, 3 cases were characterized by giant solitary cystic solid mass in abdominal cavity, 2 cases with cystic mass with wall nodule, 2 cases with mild and moderate enhancement of solid component after enhancement) 3 cases with benign cystic PM.The findings were single cystic or polycystic fluid density mass, thin and homogeneous cystic wall in 2 cases, without enhancement in 2 cases, and highly differentiated papillary PM in 2 cases.The findings included irregular cystic solid mass in adnexal region with calcification in 1 case and a small amount of pelvic effusion in 1 case.Conclusion the CT findings of PM are diverse and malignant patients have some relative characteristics. Combining with clinical data and differential diagnosis and comprehensive analysis, the diagnostic level of PM can be improved.
【作者单位】：华中科技大学同济医学院附属普爱医院放射科;温州医科大学附属第一医院放射科;
【分类号】：R730.44;R735.5

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